Experiencing neutropenia: Quality of life interviews with adult cancer patients

Abstract

Background: Neutropenia is a common toxicity in chemotherapy but detailed information about how neutropenia is associated with changes in patients' quality of life is not readily available. This prospective study interviewed patients with grade 4 neutropenia to provide qualitative information on patients' experience of developing and coping with grade 4 neutropenia during a cycle of chemotherapy.

Measuring health-related quality of life and neutropenia-specific concerns among older adults undergoing chemotherapy: validation of the Functional Assessment of Cancer Therapy–Neutropenia (FACT-N)

“…Cross-sectionally, participants with grade 3/4 neutropenia reported worse social well-being and greater worry about infection than those who did not have grade 3/4 neutropenia. This finding is consistent with results published by Fortner et al [11,12] that patients with grade 4 neutropenia had higher scores on measures of pain and anxiety and decreased levels of social activity. However, based on longitudinal analysis, participants who developed Change in FACT-N scores from the start of the chemotherapy cycle and the expected nadir did differentiate between patients who were neutropenic and those who were not, but there does not appear to be a linear relationship between ANC and HRQL, as measured by the FACT-N.…”

“…In addition, patients' self-reported HRQL is a measure of their perceptions regarding their health status. Specifically with regard to neutropenia, their neutropenia history, expectations and concerns about what neutropenia means in terms of risk of febrile neutropenia, and on their cancer care is likely to be an important component of HRQL, especially for the Worry subscale [11,12]. Flu-like symptoms are most prominent when patients develop febrile neutropenia.…”

“…Three NS items did not load on a subscale and were retained in the 19-item NS based on item-total correlations and Cronbach's alpha values. Results from qualitative interviews conducted by Fortner et al [12] support the relevance of items to assess fatigue, interference in daily functioning, emotional impact, and impact on social functioning and relationships. Reliability of the FACT-N, NS, and TOI-N was satisfactory.…”

“…These effects were measured up to 1 week after the grade 4 neutropenia event. In another study, Fortner et al [12] conducted qualitative interviews with 34 patients who had grade 4 CIN during the first cycle of chemotherapy. Fatigue was the most prominent symptom of CIN.…”

Neutropenia onset, Severity and their Association with Solid Cancer Diseases

“…Neutropenia is highly caused by antineoplastic drugs and regimens in case of solid cancer patients while neutropenia causes within patients with hematological malignant diseases different. These chemotherapeutics drugs or regimens will cause bone marrow suppression lead to decreases in neutrophil cell production resulted in neutropenia, just like in breast cancer disease 78% of the patient their neutropenia is because of the uses of CMF (cyclophosphamide, methotrexate and 5-flurouracil) [1][2][3][4][5][6][7][8]. But in many times these chemotherapeutics will not cause neutropenia this is because of their intensive effect is not high enough to cause bone marrow suppression also because of the interval period between one cycle and other in long enough so neutropenia will overcome and no increases in its severity beside the uses of G-CSF will also help in reducing the time for neutrophil cell production and reducing or preventing neutropenia onset and severity [9].…”