Patterns of Anthracycline-Based Chemotherapy-Induced Adverse Drug Reactions and Their Impact on Relative Dose Intensity among Women with Breast Cancer in Ethiopia: A Prospective Observational Study
Table 2
Overall grade toxicity profile, the pattern of G-CSF use, and treatment delay among breast cancer patients who received AC and AC-T chemotherapy at TASH, from January 1 to September 30, 2017 GC.
Chemotherapy cycles
Variables
1
2
3
4
5
6
7
8
N (%)
146 (%)
146 (%)
146 (%)
146 (%)
100 (%)
100 (%)
75 (%)
75 (%)
Hematological toxicities
Neutropenia
44 (30)
57 (39)
57 (39)
59 (40.4)
18 (18)
13 (13)
10 (13.3)
5 (6.8)
Grade 3
20 (13.7)
9 (6.2)
22 (15.1)
23 (15.8)
6 (6)
1 (1)
2 (2.7)
—
Grade 4
3 (2.1)
6 (4.1)
5 (3.4)
5 (3.4)
2 (2)
2 (2)
—
—
Leukopenia
38 (26)
49 (34)
52 (35.6)
68 (46.6)
17 (17)
20 (20)
8 (10.7)
10 (13.5)
Grade 3
2 (1.4)
—
3 (2.1)
1 (0.7)
—
1 (1)
1 (1.3)
1 (1.3)
Grade 4
—
—
—
—
—
—
—
—
Anemia
22 (15.1)
24 (16)
29 (19.9)
31 (21.2)
17 (17)
13 (13)
10 (13.3)
9 (12.2)
Grade 3
1 (0.7)
—
2 (1.4)
—
—
—
—
—
Grade 4
—
—
—
—
—
—
—
—
Lymphopenia
27 (18.5)
29 (20)
56 (38.3)
46 (31.5)
28 (28)
21 (21)
9 (12)
12 (16.2)
Grade 3
1 (0.7)
—
2 (1.4)
2 (1.4)
2 (2)
2 (2)
—
—
Grade 4
—
—
—
—
—
—
—
—
Thrombocytes
2 (1.4)
3 (2.1)
2 (1.4)
5 (3.4)
2 (2)
2 (2)
1 (1.3)
1 (1.3)
Grade 3
—
—
—
—
—
—
—
—
Grade 4
—
—
—
—
—
—
—
—
Nonhematological toxicities
AST ↑
12 (8.2)
11 (7.5)
16 (11)
16 (11)
11 (11)
10 (10)
7 (9.3)
7 (9.5)
Grade 3
—
2 (1.4)
—
—
—
—
—
—
Grade 4
—
—
—
—
—
—
—
—
ALT ↑
7 (4.8)
4 (2.7)
5 (3.4)
8 (5.5)
9 (9)
9 (9)
7 (9.3)
7 (9.5)
Grade 3
2 (1.4)
—
—
—
—
1 (1)
—
—
Grade 4
—
—
—
—
—
—
—
—
ALP ↑
22 (15.1)
19 (13)
17 (11.6)
17 (11.6)
18 (18)
18 (18)
9 (12)
11 (14.9)
Grade 3
2 (1.4)
—
—
1 (0.7)
1 (1)
1 (1)
1 (1.3)
1 (1.3)
Grade 4
—
—
—
—
—
—
—
—
Cr ↑
11 (7.5)
9 (6.7)
13 (8.9)
8 (5.5)
3 (3)
5 (5)
4 (5.3)
2 (2.7)
Grade 3
—
—
—
—
—
—
—
—
Grade 4
—
—
—
—
—
—
—
—
Infection
1 (0.7)
2 (1.4)
6 (4.1)
0 (0)
2 (2)
2 (2)
4 (5.3)
0 (0)
Grade 3
—
—
—
—
—
—
—
—
Grade 4
—
—
—
—
1 (1)
—
—
—
Nausea ##
123 (84.3)
124 (85)
124 (84.9)
110 (75.3)
36 (36)
26 (26)
7 (9.3)
5 (6.8)
Grade 3
31 (21.2)
24 (16.4)
14 (9.6)
18 (12.3)
1 (1)
1 (1)
—
—
Vomiting
92 (63)
88 (60.3)
96 (65.8)
86 (58.9)
24 (24)
19 (19)
1 (1.3)
1 (1.3)
Grade 3
12 (8.2)
7 (4.8)
10 (6.8)
14 (9.6)
—
—
—
—
Grade 4
—
—
—
—
—
—
—
—
OM
41 (28.1)
53 (36.3)
52 (35.6)
50 (30.2)
14 (14)
17 (17)
8 (10.7)
8 (10.8)
Grade 3
5 (3.4)
8 (5.5)
6 (4.1)
9 (6.2)
2 (2)
2 (2)
—
—
Grade 4
—
—
—
—
—
—
—
—
Fatigue ##
136 (93.2)
135 (92.5)
134 (91.8)
125 (85.6)
83 (83)
79 (79)
51 (68)
49 (66.2)
Grade 3
3 (2.1)
1 (0.7)
5 (3.4)
6 (4.1)
3 (3)
—
2 (2.7)
2 (2.7)
PNP
32 (21.9)
44 (30.1)
43 (29.5)
51 (34.9)
66 (66)
67 (67)
64 (85.3)
63 (85.1)
Grade 3
—
—
1 (0.7)
—
16 (16)
15 (15)
15 (20)
14 (18.9)
Grade 4
—
—
—
—
—
—
—
—
Supportive measures given
G-CSF use
9 (6.2)
9 (6.2)
17 (11.6)
15 (10.3)
5 (5)
2 (2)
2 (2.7)
0 (0)
Antibiotic$
9 (6.2)
9 (6.2)
17 (11.6)
15 (10.3)
5 (5)
2 (2)
2 (2.7)
0 (0)
T. Delay#
17 (11.6)
9 (6.2)
31 (21.2)
21 (14.4)
8 (8)
6 (6)
3 (4)
0 (0)
“—” = no grade 3 or 4 toxicity reported; grade 3 and grade 4 represent a severe and life-threatening form of adverse drug reactions, respectively. Thrombocytopenia. Granulocyte colony-stimulating factor use for different grade neutropenia. $Antibiotic use was oral ciprofloxacin 500 mg twice a day for seven days. #T.delay = treatment delay due to toxicity. OM = oral mucositis; PNP = peripheral neuropathy. ##Grade 4 and above are not available for nausea and fatigue on the PRO part of NCI CTCAE (version 4.03).
