Hematologic Adverse Effects following Systemic Chemotherapy
Shahrasbi A
*
, Armin A, Ardebili A, Rafie KS, Ansari M and Rabani M
Hematology-Oncology Section, Booali Hospital, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
*
Corresponding author: Shahrasbi A, Hematology-Oncology Section, Booali Hospital, Tehran Medical Branch, Azad University, Tehran, Iran, Tel: 00989121309264; E-
mail: a_shahra@hotmail.com
Received date: May 28, 2017; Accepted date: June 20, 2017; Published date: June 24, 2017
Copyright: © 2017 Shahrasbi A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Cytopenia is one of the most important side effects of chemotherapy. It presents as pancytopenia
or bicytopenia or monocytopenia. Cytopenia is a challenging factor for delivering chemotherapy drugs.
Methods: In this study we were looking for the incidence of cytopenia in patients received chemotherapy in two
different hospitals.
Results: 200 patients were included in our study. Most of the patients were female and anemia was the most
adverse effect which was followed by leukopenia and thrombocytopenia. Bicytopenia and pancytopenia were the
least side effects of chemotherapy drugs.
Conclusion: Although our study was not a head to head one anemia was the most adverse effect following
systemic chemotherapy in both hospitals. Overall cytopenia was more prevalent in the university hospital than
private hospital. This difference was significant for anemia (P-value ≤ 0.05) but it wasn’t for leukopenia or
thrombocytopenia. Bicytopenia and pancytopenia happened very rarely.
Keywords: Hematologic adverse effects; Cytopenia; Chemotherapy
Introduction
Hematologic toxicity induced by chemotherapy is called cytopenia.
Cytopenia (Pancytopenia) is described as decreasing of all three types
of blood cells including Red blood cells (Anemia), White blood cells
specially neutrophils (Leukopenia-Neutropenia) and Platelets
(rombocytopenia). is condition is one of the most serious
complications of chemotrapeutic drugs which can be led to mortality
and morbidity directly or indirectly [1-4].
Anemia complicates cancer management. It causes fatigue, one of
the most side effects of malignancy treatment. It may also decrease the
effectiveness of chemotherapy drugs on malignant cells. Neutropenia is
known as the most serious adverse effect of chemotherapy usually
makes physician reduce the drug dosage or limit the drug
administration which in many cases leading to treatment failure. Due
to decreased amount of neutrophils in blood, there is a higher risk for
dangerous infection [1-13].
On the other hand thrombocytopenia increases the risk of bleeding
and sometimes makes physician decrease the dosage of chemotherapy
drugs which in turn compromises treatment results.
According to a report published in 1997, dose reduction about 20%
reduces the treatment success about 50%. So, it is very important to
adjust the dose of chemotrapeutic agents properly to prevent
unpleasant adverse effects and also to have a more successful treatment
[14-18].
Material and Methods
e current study is performed to find incidence of cytopenia in
patients with different cancers who were receiving standard
chemotherapy regimens. From March 20, 2016 to June 20, 2016; 200
patients with different histopathology proven cancers were admitted to
Booali university hospital (BUH) (100 patients) and Tehran private
hospital (TPH) (100 patients) in order to receive chemotherapy
(minimum two cycles and maximum six to eight cycles).
Before starting chemotherapy a few tests including complete blood
cell count (CBC) and cell differentiation, kidney function test, and
liver function test and extra tests as needed were done. Hematologic
toxicities including Anemia, Neutropenia, rombocytopenia, or
combined form were considered.
Anemia is described as the hemoglobin concentration ≤ 10 g/dL.
Neutropenia was considered when neutrophils count was ≤ 1500/µL
and thrombocytopenia when platelets count was ≤ 100000/µL. All
patients with primary decrease of each of blood cell components
excluded from the study. Before each cycle of chemotherapy CBC and
Liver and kidney function tests were considered and each
abnormalities corrected by blood product transfusions or colony
stimulating factors and supportive management for other biochemistry
lab issues.
Most of our patients in both hospitals have been divided into three
groups according to their pathologic reports including breast cancer,
GI malignancies and others. Patients with ECOG performance 0 or 1
were chosen at both hospitals. We used Pearson’s chi-squared test to
compare the results as the statistical method.
Shahrasbi et al., J Oncol Med & Pract 2017, 2:1
Research Article Open Access
J Oncol Med & Pract, an open access journal Volume 2 • Issue 1 • 110
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Journal of Oncology Medicine &
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