title: Incidence of febrile neutropenia among early-stage breast cancer patients receiving anthracycline-based chemotherapy.
abstract: OBJECTIVE
  The aim of this study was to investigate the incidence of febrile neutropenia (FN) with adjuvant AC (doxorubicin and cyclophosphamide) chemotherapy among Asian early-stage breast cancer (ESBC) patients, to evaluate the impact of FN on chemotherapy delivery, and to identify specific risk factors that would predispose ESBC patients to FN.
  
  
  METHODS
  This was a single-center, observational, retrospective cohort study conducted in Singapore. All ESBC patients who have received the AC regimen as adjuvant chemotherapy between January 2007 and July 2010 were included into the study. Patients did not receive granulocyte colony-stimulating factors (G-CSF) as primary prophylaxis.
  
  
  RESULTS
  One hundred and eighty-nine patients and 729 cycles of chemotherapy were analyzed in this study, of which, majority were Chinese (84%). Median age of the patients was 54 years old (IQR 49-58). In total, 26 patients (13.8%) manifested at least one episode of FN, of which 17 patients developed FN during the first cycle of treatment. Patients who manifested FN received similar dose intensities of chemotherapy, compared to those patients who did not manifest FN (100% versus 98%, p = 0.95). After adjusting for age, race, and presence of comorbidities, low body mass index (BMI) (<23 kg/m(2)) was found to be associated with a higher risk of FN (OR 4.4, 95% CI = 1.65-12.01, p = 0.003).
  
  
  CONCLUSIONS
  Asian patients are at moderate risk for FN when they receive the AC regimen for treatment of ESBC. Further studies should evaluate the role of G-CSF to reduce the occurrence of FN in Asian patients with low BMI.
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543 Singapore. phaac@nus.edu.sg
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chan
authors.forename: Christy
authors.initials: C
authors.lastname: Chen
authors.forename: Joen
authors.initials: J
authors.lastname: Chiang
authors.forename: Sze Huey
authors.initials: SH
authors.lastname: Tan
authors.forename: Raymond
authors.initials: R
authors.lastname: Ng
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide