Hematological Toxicity during Breast Cancer Chemotherapy in Pointe-Noire (Congo Brazzaville)

Introduction: The objective of our study was to determine the prevalence of hematological toxicity during breast cancer chemotherapy. Patients and Methods: This was a cross-sectional descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2021 to December 31, 2021, i.e. a period of 1 year. Were included in our study: patients with and histological diagnosis, and having received at least two cycles of chemotherapy and having presented hematological toxicity: anemia and/or neutropenia. The variables studied were: Age, level of study, socioeconomic level, stage of extension, type of chemotherapy, type of toxicity: neutropenia and anemia. Bivariate analysis was done between anemia, neutropenia and type of chemotherapy. Results: The average age of the patients was 50.35 ± 13.6 years. The extremes were 27 years and 79 years old. The most represented age group was the age group from 37 to 46 years with 18 cases or 33.33%. The most represented level study in our study was the primary level 63%, followed by secondary level 26% and the upper or superior level 11%. Metastatic stage of location was represented in 16.6% of cases, the local stage was represented in 16.7% of cases. The most common chemotherapy used was FAC protocol in 50% of cases, followed by FAC + DOCETAXEL in 47% of cases, AC protocol was used in 3% of cases. The most represented grade of neutropenia was grade 3 in 53% of cases, followed by grade 2 in 27% of cases and grade 1 in 20%. Grade 1 anemia was the most represented in 70% of cases, followed respectively by grade 2 in 27%. The majority of patients had received more than 3 courses of chemotherapy in 83% of cases. Grade 3 neutropenia was observed mostly in the advanced stages, 15 cases at the locoregional stage. Grade 1 anemia was most common in patients who received more than 3 courses of chemotherapy. The FAC chemotherapy protocol was responsible for more grade 3 anemia in 14 cases. FAC-type chemotherapy was associated with grade 3 and 2 neutropenia in 8 cases and 4 cases, but the results were not significant. FAC + DOCEAXEL type chemotherapy was also responsible for grade 3 and 2 neutropenia in 8 cases and 4 cases P > 5% respectively. Conclusion: Hematological toxicity in the context of our limited resources is dominated by anemia and neutropenia. The knowledge of this hematological toxicity is necessary for the limitation of the delay of chemotherapy.

Hematologic toxicity of gemcitabine: a comparison between fixed-dose rate infusion and thirty-minute infusion in the treatment of malignancy

Objective： The aim of the study was to compare the hematologic toxicity of gemcitabine between fixed-dose rate （FDR） infusion and 30-minute standard infusion in the treatment of malignancy. Methods： The 25 malignancy patients confirmed by histopathology or cytology received single-agent gemcitabine or gemcitabine in combination with other chemo- therapeutic agents. These patients were randomly divided into gemcitabine 1000 mg/m2 on dl, d8 at a rate of 10 mg/m2/min arm （FDR arm） or 30 rain arm （standard arm）, every 21 days one cycle. Hematologic toxicity was evaluated at the end of each cycle. Results： The 13 of 25 patients received gemcitabine FDR therapy, a total of 28 cycles was completed, and 32 cycles in the others （12 of 25 patients） with the standard arm. All patients were evaluable for hematologic toxicity. The result showed that the grades 3-4 leucopenia was significantly different between the two arms （14.3% vs 0, P 〈 0.05）, and no significant differences of neutropenia, thrombocytopenia and hemoglobin suppression of grades 3-4 （14.3% vs 3.1%, 10.7% vs 3.1%, 3.6% vs 9.4%, P 〉 0.05, respectively） were observed between the two arms, no grade 4 of hemoglobin suppression was observed. Conclusion： Hematologic toxicity of gemcitabine therapy at a fixed-dose rate for malignancy is tolerable.