Prognostic Value of Chemotherapy-Induced Neutropenia at the First Cycle in Invasive Breast Cancer

Abstract

Chemotherapy-induced neutropenia (CIN) was the most apparent side effects of bone marrow suppression with adjuvant chemotherapy. Recently, several studies revealed that CIN may predict better outcomes. However, the researches upon breast cancer were still indefinite.We reviewed the female patients with pathologically diagnosed invasive breast cancer at the First Affiliated Hospital of Wenzhou Medical University, between Jan 2008 and Dec 2010. The lowest neutrophil counts in the second week after the first cycle of chemotherapy were collected. Clinicopathological characteristics and survival rates were compared and analyzed between the CIN group and non-CIN group.The median follow-up time was 62 months. The differences of over-all survival and local recurrence-free survival between the 2 groups were nonsense (P = 0.938, P = 0.695, respectively). But the disease-free survival and distant metastasis-free survival of the CIN group were statically significantly better (HR = 0.391, P = 0.009, and HR = 0.315, P = 0.005, respectively). The bone metastasis-free survival may be responsible for the differences (HR = 0.469, P = 0.005). Subgroup analyses showed the CIN may predict lower bone metastases rates with ER positive status, premenopause or younger age (≤ 40) (P = 0.002, P = 0.004, and P = 0.0001, respectively). Cox analysis showed younger ages, N staging, and the presence of CIN were associated with bone metastasis-free survival independently adjusting to peritumoral vascular invasion (P < 0.05).CIN may predict a decreased recurrence risk of breast cancer, especially bone metastases.

Peripheral Blood Classical Monocytes and Plasma Interleukin 10 Are Associated to Neoadjuvant Chemotherapy Response in Breast Cancer Patients

“…Finally, we calculated the monocyte/lymphocyte ratio; Figure 1D shows an increase in AMC/ALC during the first NAC cycles followed by a drastic decrease after the 5th cycle, concomitant to the switch in chemotherapeutic drug. Both lymphopenia ( 22 ) and neutropenia ( 23 ) are commonly seen in patients under CT treatment and could explain this decrease.…”

Calf Spleen Extractive Injection protects mice against cyclophosphamide-induced hematopoietic injury through G-CSF-mediated JAK2/STAT3 signaling

“…Within the bone marrow microenvironment, hematopoietic stem cells can be differentiated into directional progenitor cells and precursor cells, and finally differentiated or matured into various hemocytes with different functions 38 , including neutrophils and B cells. Studies have shown that lentinan can increase the bone marrow neutrophils in mice with therarubicin-induced myelosuppression 39 , 40 . The antioxidant chlorophyllin enhances bone marrow granulopoiesis, substantially increases peripheral blood neutrophils and further alleviates radiation-induced hematopoietic syndrome 41 .…”

Current management of chemotherapy-induced neutropenia in adults: key points and new challenges

“…Several studies have shown that CIN may predict favorable prognoses and therapeutic results in some cancers. These studies showed that CIN may be associated with better survival [progression-free survival (PFS) and/or overall survival (OS)] or a lower recurrence risk in breast cancer 1 , gastric cancer 2 , cervical cancer 3 , pancreatic cancer 4 , lung cancer 5 , colorectal cancer 6 , and ovarian cancer patients 7 .…”