Neutropenia in breast cancer patients receiving Paclitaxel as chemotherapy: a study in a tertiary care centre in Northeast India

Background and aims: Chemotherapy-induced neutropenia (CIN) is one of the most common side effects in breast cancer patients receiving myelosuppressive chemotherapy like Paclitaxel which adversely affect patient outcomes. Materials and methods: A single centre, retrospective, observational study was conducted on 210 breast cancer patients with prior adequate bone marrow, hepatic and renal functions, receiving Paclitaxel as neoadjuvant or adjuvant or palliative chemotherapy from January 2018 to April 2019 at State Cancer Institute (SCI), Guwahati, Assam, India. Patients with a history of taking immunosuppressive agents, immunodeficiency states, hematological disease and any intercurrent illness were excluded from this study. Paclitaxel was given two weekly for four cycles at a dose of 175mg/m2 in each cycle. A total of 836 cycles were observed for 210 patients, while four patients did not complete the last cycle due to peripheral neuropathy. Results: The average age of the patients was 49.44±9.13 years. Among 210 patients, 82 patients presented with neutropenia (39.02%), while total neutropenia episodes were 128 (15.31%). Seven patients presented with febrile neutropenia (FN) out of 82 patients who received Paclitaxel (8.54 %). Prior incidence of CIN, advanced age, poor performance status and lower baseline Hb% were found as risk factors for CIN. Conclusion: The incidence of CIN and CIN episodes was 39.02% and 15.31%, respectively, in our study. Hence judicious use of Granulocyte colony-stimulating factor (G-CSF) as prophylaxis in our populations with close monitoring and as needed may be undertaken. However, the limitations of our study were the small sample size. Hence, further studies are necessary for a large scale population to confirm the findings of our research.