NADIR NEUTROPHIL COUNTS m PATIENTS TREATED I ?OR BREAST CANCER WITH DOXORUBICIN AND CYCLOPHOSP: IIAMIDE

Abstract

Objective: To determine the impact on neutrophils if adriamycin is administered at 60 mg/
mz and cyclophosphamide at 6001m2 (AC 601600); and at 50 rng/m2 and 500 mg/m2 (501500)
in the treatment of breast cancer.
Design: Retrospective analysis of nadir neutrophil counts ill female mammary carcinoma
patients treated with adriamycin/cyclophosphamide combination.
SeTting: Hurlingham Oncology Clinic, Nairobi and The Nairobi Hospital between March
1995 and August 1999.
Subjects: Eighteen patients with breast cancer were treated either for adjuvant purposes or
for metastatic disease.
Intervention: Chemotherapy with adriamycin and cyclophosphamide at 601600 or 501500.
Patients were advised to avoid crowded places and given prophylactic broadspectrum
antibiotics whenever grade 4 neutropenia occurred at nadir.
Results: Grade 3 - 4 neutropenia occurred in 75.5 % of treatn tents at 601600 and in 56.8% of
the treatments at 501500. Febrile neutropenia followed only o le treatment and did not result
in death.
Conclusion: Neutropenia is frequent and severe at AIC 6016 I0 and need to be watched out
for. Sepsis on the other hand is prevented if meticulous attention is given and corrective
measures taken. AIC 501500 was associated with less occurre] Ices of neutropenia though still
very high. Neutropenia should therefore be checked and steps be taken to prevent sepsis even
at this dosage.