Main Determinants of Severe Neutropenia in Patients with Solid Tumors Receiving Adjuvant Chemotherapy

Abstract

Background:Chemotherapy-induced neutropenia as a major toxicity of systemic chemotherapy is commonly associated with substantial mortality and morbidity, and thus identifying its determinants is necessary. This study was undertaken to identify main risk factors of severe neutropenia following adjuvant chemotherapy treatment in a community-based population of patients with cancer in Semnan, Iran. Materials and methods: This prospective study included 828 consecutive patients with histologically proven primary or metastatic solid tumors who received chemotherapy. Demographics data, disease characteristics, and co-morbidities (including current smoking and diabetes) were collected by face to face interviews with the patients and also by referring to their laboratory data and files. Patients underwent complete blood count a week after the first chemotherapy course. Results: Based on the nadir value of the absolute neutrophil count (ANC), 30 patients (3.6%) had severe neutropenia. Multivariable logistic regression analysis showed that advanced age (OR = 5.262, p = 0.012), and the presence of diabetes mellitus (OR = 8.126, p = 0.015) were the main determinants for the appearance of severe neutropenia with the presence of demographics and studied co-morbidities as confounders. Conclusion: We identified advanced age and the presence of diabetes as the main determinants of high-grade neutropenia in solid tumor patients receiving adjuvant chemotherapy in our study population. Keywords: Neutropenia, solid tumor, chemotherapy.