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Validation of Risk of Chemotherapy-Induced Neutropenia: Experience from Oncology Hospital of Nepal

Authors Sapkota B, Shrestha R, Chapagai S, Shakya DK, Bista P

Received 27 December 2019

Accepted for publication 7 May 2020

Published 20 May 2020 Volume 2020:12 Pages 3751—3758


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Beicheng Sun

Binaya Sapkota,1 Ronash Shrestha,2,* Safin Chapagai,1,* Dip Kiran Shakya,1,* Prashant Bista1,*

1Nobel College Faculty of Health Sciences, Department of Pharmaceutical Sciences, Sinamangal, Kathmandu, Nepal; 2Aadee Remedies Pvt. Ltd, Imadol, Lallitpur, Nepal

*These authors contributed equally to this work

Correspondence: Binaya Sapkota
Nobel College Faculty of Health Sciences, Department of Pharmaceutical Sciences, Sinamangal, Kathmandu, Nepal

Background: The majority of cancer patients undergoing chemotherapy show neutropenic condition which is a common side effect of myelosuppressive chemotherapy diagnosed as the reduced complete blood cell count. Such cancer patients have a higher risk of febrile neutropenia. The present study aimed to validate whether there was a risk of neutropenia in cancer patients receiving chemotherapy at Bhaktapur Cancer Hospital, Nepal.
Methods: Cross-sectional study was performed among 203 cancer patients of all age groups who attended Bhaktapur Cancer Hospital from May 2018 to January 2019 and who received a chemotherapy course. Patients receiving at least one cycle of chemotherapy as the first-line treatment were included. Statistical analysis was performed using SPSS 25. Loglinear analysis was used to analyze more than 2× 2 categories among the grades and outcome of neutropenia. Multinomial logistic regression was applied to analyze the impact of various predictor variables such as chemotherapy cycles, grades of neutropenia, and gender on the outcome of neutropenia. Variation in the absolute neutrophil count (ANC) level at various days of chemotherapy cycles was assessed with the multivariate analysis of variance (MANOVA). The p-value < 0.05 was considered significant at each condition.
Results: The main cancer type during the study period was breast cancer (41, 20.2%). Out of 163 neutropenic patients, 149 had severe neutropenia and 14 had mild neutropenia. Most patients were continued up to the 6th cycle of chemotherapy. There was significant association between the grade of neutropenia and the outcome of the condition (p-value 0.017). There were significant relations of the grade of neutropenia and smoking habit with the recovering status (p values 0.033 and 0.001, respectively). The absolute neutrophil count (ANC) level increased and decreased inconsistently (statistically non-significantly) in between treatment period of day 1 to 52.
Conclusion: Chemotherapy-induced neutropenia was a common occurrence. Majority (133, 66.5%) grade 4 neutropenic patients were recovering after the chemotherapy cycles. The physicians are warranted that they be ready for any unpredictable situation during chemotherapy treatment.

Keywords: chemotherapy-induced neutropenia, chemotherapy, febrile neutropenia, myelosuppressive, Nepal

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