Lim Hsuen Elaine, Wong FY, Li Jing Mei

Chemotherapy Induced Febrile Neutropenia in Singapore Breast Cancer Patients 

Abstract Disclosures

Abstract

Background: Breast cancer is the most common cancer in Singapore. Breast cancer patients are treated curatively and aggressively with chemotherapy at SingHealth and its partner institutions. Febrile neutropenia (FN) is a complication of myelosuppressive chemotherapy, with possible consequences of dose delay, dose reduction, and treatment truncation. The use of prophylactic granulocyte colony-stimulating factors (GCSF) is non-uniform. There have been reports of a higher incidence of FN in Asian patients as compared with Caucasians. Early identification of FN and a careful assessment of the baseline risks for FN, enables the selection of patients who require primary prophylactic GCSFs. Patients receiving GCSF experience shorter duration of neutropenia, faster recovery from fever, and shorter duration of antibiotics use. 

Objectives: In this retrospective study, we aim to quantify the contribution of various patients, tumors, sociodemographic and chemotherapy regimens and their dose, rates of FN episodes, hospitalization, chemotherapy disturbance, change in BMI and FN in each cycle of chemotherapy, sensitivity tests comparing neutropenia and FN or composite outcome in breast cancer patients in Singapore. The study aims to report the trend in neutropenia and the outcomes of chemotherapy-induced neutropenia (CIN)/FN in patients with breast cancer who received different chemotherapy regimens.  

Method:. Data on neutropenia and the outcomes of CIN/FN in patients diagnosed with breast cancer from 2005 to 2020 for each racial/ethnic group, will be extracted from the Joint Breast Cancer Registry database. Date of FN hospitalisation, including Accident & Emergency Department visit and absolute neutrophil count will be retrieved from eHInts data warehouse. Records of patients receiving GSCF drugs will be used to do a comparison with patients who did not receive GCSF drugs. Contributing factors to survival disparities will be estimated from a sequence of multivariable Cox proportional hazards models. 

Joint Breast Cancer Registry Singapore