Chemotherapy-Induced Neutropenia in Palestinian Patients with Solid Malignancies: Patient Characteristics, Severity Risk Factors, and Management Patterns.

UNLABELLED: Neutropenia is an adverse event of systemic chemotherapy with various complications that affect patient management, quality of life, and could be fatal. The study was conducted to evaluate chemotherapy-induced neutropenia (CIN) in a Palestinian cohort of patients with solid malignancies. This article examines patient characteristics, risk factors for neutropenia severity, and neutropenia management patterns. The study included a total of 171 adult patients diagnosed with solid malignancies who were on their first chemotherapy regimens with no history of neutropenia. Data were collected retrospectively from patients' electronic medical records. Only patients who developed neutropenia during treatment were included in this study, and patients were classified into three groups of severity based on the absolute neutrophil count (ANC). Colon cancer and lung cancer were the most reported. Epirubicin, paclitaxel, cyclophosphamide, and doxorubicin were significantly associated with neutropenia severity, in addition to the number of chemotherapy cycles, stage at diagnosis, and certain comorbidities. Of the total patients, 32.5% reported substance use which was also significantly associated with severity. The majority of patients received primary granulocyte colony-stimulating factor (GCSF) prophylaxis. Sixty-nine percent of patients presented with febrile neutropenia. Hospitalization, antibiotics, antipyretics, and GCSF were utilized for management in most patients. Neutropenia severity was associated with the chemotherapy agents used, whereas the type of solid malignancy was not. Substance use represented a high burden among our cohort, and its association with severity could be further studied. Primary GCSF prophylaxis is critical, with patients not receiving it developing profound neutropenia (ANC <0.1 × 109) at higher rates.

SIGNIFICANCE: CIN causes high utilization of medical resources and disrupts treatment schedules. Factors possibly associated with severity include stage at diagnosis, number of chemotherapy cycles, select agents, and comorbidities. GCSF prophylaxis possibly decreases profound neutropenia rates. Palestinian patients with cancer have a high burden of substance use, possibly reflecting unmet needs.