title: The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy.
abstract: BACKGROUND
  Chemotherapy-induced amenorrhea (CIA) is common in young breast cancer patients. The incidence of CIA associated with regimens involving epirubicin and taxane was not well known. Furthermore, previous studies suggested leucopenia and amenorrhea may reflect inter-individual variations in pharmacokinetics. The purpose of this study was to investigate the association between leucopenia after first cycle of chemotherapy and CIA in young breast cancer patients receiving epirubicin and taxane based chemotherapy. Furthermore, the incidence of CIA was also assessed.
  
  
  RESULTS
  Between October 2008 and March 2010, 186 consecutive premenopausal patients, treated with epirubicin and taxane based chemotherapy, were recruited. Information about CIA was collected by telephone and out-patient clinic. Of these 186 patients, data from 165 patients were included and analyzed. Of all 165 patients, CIA occurred in 72 patients (43.64%). In multivariate analysis, age older than 40 y (OR: 16.10, 95% CI: 6.34-40.88, P<0.001) and previous childbearing (OR: 3.17, 95% CI: 1.06-9.47, P = 0.038) were significantly associated with probability of CIA. Compared to patients treated without taxane, patients treated with taxane-contained regimens did not have a significantly higher rate of CIA (P>0.05). The rate of CIA in leucopenia group (52.56%) was significantly higher than that in normal leukocyte group (34.62%) (P = 0.024). In patients treated with a FEC regimen (cyclophosphamide, epirubicin and 5-fluorouracil), the rate of CIA in leucopenia group (59.57%) was significantly higher than that in normal leukocyte group (36.84%) (P = 0.037).
  
  
  CONCLUSIONS
  Age at diagnosis and previous childbearing were both found to significantly increase the risk of CIA, whereas additional taxane was not associated with increased rate of CIA. Importantly, leucopenia after first cycle of chemotherapy was associated with increased risk of CIA, which suggested that leucopenia may be an early predictor of chemotherapy-induced infertility.
authors.affiliation: Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Zhou
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
authors.forename: Xiuqing
authors.initials: X
authors.lastname: Liang
authors.forename: Zhongyuan
authors.initials: Z
authors.lastname: He
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Zha
authors.forename: Xiaoan
authors.initials: X
authors.lastname: Liu
authors.forename: Shui
authors.initials: S
authors.lastname: Wang
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced* / Q000453:epidemiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D044466:Asian People; D001943:Breast Neoplasms / Q000188:drug therapy*; D002681:China / Q000453:epidemiology; D015251:Epirubicin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced / Q000150:complications*; D008875:Middle Aged; D017697:Premenopause; D012189:Retrospective Studies; D043823:Taxoids / Q000009:adverse effects*
chemical_list: D043823:Taxoids; D015251:Epirubicin