Incidence and attributes of chemotherapy induced myelotoxicity, anemia and neutropenia in adults with cancer in Nepal: A cross-sectional observational study

Abstract

Background Myelosuppression remains a major toxicity in cancer patients receiving chemotherapy, and is associated with considerable morbidity, mortality and cost. Objective The present study aims to investigate the prevalence and incidence of myelotoxicity, anemia and neutropenia in the adult cancer population, and further to determine the factors influencing them. Methods This was a cross-sectional observational study conducted at National Academy of Medical Sciences, Bir Hospital, Kathmandu. A total of 170 subjects eligible for the study were enrolled for analysis. Prevalence and incidence of myelotoxicity anemia, neutropenia and myelotoxicity at enrollment and during study were investigated. Factors influencing development of myelotoxic event were determined. Results Of 170 enrolled patients, the prevalence of myelotoxicity, anemia and neutropenia at enrolment was 54 (31.8%), 20 (11.8%) and 28 (16.6%), respectively, with 27 (16%) mild and 12 (7.1%) moderate type of anemia. Incidence of myelotoxicity, anemia and neutropenia during treatment was 90 (52.94%), 44 (26%) and 53 (31.2%) respectively, with 70 (41.2%) mild, 39 (22.9%) moderate and 5 (2.9%) severe type of anemia. Age (OR: 0.49; p < 0.047), and baseline Hb (OR: 1.29; p < 0.01) were found to be independent predictors associated with anemia. Hb (OR: 2.42, CI: 1.79-3.28; p < 0.001) and smoking (OR: 0.49: p = 0.03) were found to be independent factors associated myelotoxicity. Conclusion Our study confirmed a high incidence rate of myelotoxicity, neutropenia and anemia in a considerable number of Nepalese cancer patients receiving chemotherapy, and that baseline Hb, smoker and older adults are at more risk, these patients should be evaluated carefully and a prophylactic measure should be adopted accordingly so as to prevent toxicity and improve quality of life during cancer treatment.

Establishment of improved review criteria for hematology analyzers in cancer hospitals

“…Moreover, the samples obtained from patients in cancer hospitals are different from those in general hospitals, and thus, the available review criteria might be inapplicable for the laboratories in cancer hospitals. The number and morphology of blood cells in cancer patients are often altered due to treatment (eg, radio/chemotherapy) or other cancer‐related conditions (eg, anemia, neutropenia, and myelosuppression) 11,12 . Thus, specimens in cancer hospitals have higher positive and review rates than those in general hospitals.…”

Anemia and Bone Marrow Suppression After Intra-Arterial Chemotherapy in Children With Retinoblastoma: A Retrospective Analysis

“…Our study found that children with Rb had varying anemia severities and bone marrow suppression degrees after IAC. This study investigated 282 retinoblastoma cases; the rates of post-IAC anemia and myelosuppression in children were 64.18% and 34.40%, respectively, which were significantly higher than 31.8% and 11.8% in adult patients with cancer (28). This difference may be due to the differences in tumor types, chemotherapeutic drugs, and the potential disease status of the study population.…”

A Risk-Prediction Nomogram for Neutropenia or Febrile Neutropenia after Etoposide-Based Chemotherapy in Cancer Patients: A Retrospective Cohort Study

“…Neutropenia, a major and serious chemotherapy-related ADR, often affects the efficacy of cancer chemotherapy [5]. The incidence of neutropenia varies depending on the chemotherapy regimen, timing of medication, patient race, or research methods [18, 19]. These factors may explain why the incidence of neutropenia or FN in this study (4.0%) was quite different from that of patients using other chemotherapy regimens (20%) reported by Lyman et al [20].…”