Hematotoxicity and functional impacts related to chemotherapy with doxorubicin and cyclophosphamide for invasive ductal breast carcinoma: a study in clinical records

Abstract

Objective: To evaluate the occurrence of hematological and functional toxicities during chemotherapy with doxorubicin and cyclophosphamide in women with breast invasive ductal carcinoma. Methods: This was a descriptive, cross-sectional and quantitative study, involving the data collection in clinical records of 119 women undergoing chemotherapy for breast invasive ductal carcinoma in an oncology outpatient clinic, carried out between February 2014 and February 2015. Results: The investigated toxicities and their respectively occurrences in patients exposed to doxorubicin and cyclophosphamide were hemoglobinemia (26,5%), leukopenia (21,6%), neutropenia (10,8%), thrombocytopenia (none) and reduced hematocrit (28,4%), in addition to fatigue (93,1%), fever (20,6%), gain (35,3%) and weight loss (22,5%). In these variables, there were no significant differences between the exposed and not exposed patients. The association with taxanes showed a significant reduction in hematocrit values (p=0.019) and the toxicities distributed by age group were not significant within the exposed group. Conclusions: Exposure to doxorubicin and cyclophosphamide was not associated with an increase in the occurrence of hematotoxicities and functional impacts in women with breast ductal invasive carcinoma, except when associated with taxane agents.

Ranferon-12 tonic mitigates haematological abnormalities in cyclophosphamide-treated rats

“…Hence, measuring these peripheral blood cells count, directly mirrors the haematopoietic function (Tian et al, 2021). In line with previous studies (El-Naggar et al, 2015;Iqubal et al, 2020;Kameo et al, 2021), CPA administration at 200 mg/kg i.p. ( 24h) from the study, led to a significant decrease in RBC, Hb, PCV, WBC and PLT levels; an indication of haematological abnormalities, due to decrease in peripheral blood cells.…”

“…Haematotoxicity is one among several factors responsible for limiting the prognosis of neoplasms (Kameo et al, 2021). One of the most reported mechanisms of CPA-induced haematotoxicity is the inhibitory effect of CPA or its xenobiotic metabolite (acrolein) on DNA replication causing oxidative damage and inhibiting the haematopoietic function of bone marrow cells (e.g.…”

“…Under normal physiological conditions, haematopoietic factors regulate haematopoietic stem cells activity during haematopoiesis (Wang et al, 2011). CPA or its xenobiotic metabolite (acrolein) causes alteration in the levels of these haematopoietic factors especially haematopoietic growth factors by producing excess pyrogenic cytokines and in turn leads to fever (Kameo et al, 2021). Fever or pyrexia manifests as an increase in body temperature above the absolute temperature baseline regulated by the body's thermoregulatory center in the hypothalamus (Blatties, 2000;Pizzo, 1999).…”

“…Cyclophosphamide (CPA) is a common anticancer agent often used to improve the quality of a cancer patient's life. However, it is limited due to unpleasant side effects, e.g., haematotoxicity (Ferguson and Pearson, 1996;Iqubal et al, 2020;Kameo et al, 2021). CPA-induced haematotoxicity is a prevalent side effect that corresponds to haematopoietic impairment, which may lead to reduced levels of red blood cells (RBCs), decreased haematocrit, reduced haemoglobin counts (anaemia), leukopenia, thrombocytopenia, haemorrhage, or immunosuppression (Fraiser et al, 1991;Kameo et al, 2021).…”

Protective Effects of Omega-3 Supplementation against Doxorubicin-Induced Deleterious Effects on the Liver and Kidneys of Rats

“…Other side effects include hepatotoxicity, which affects 30.4% of patients undergoing breast cancer treatment [ 7 ], and nephrotoxicity, recently reported in patients with metastatic breast cancer [ 8 ]. Furthermore, hematological toxicities induced by DOX have already been reported in patients with these solid tumors, such as hemoglobinemia, leukopenia, and neutropenia [ 9 , 10 ]. The appearance of these complications can lead to changes in the chemotherapy or even its interruption [ 11 ].…”