Prognostic value of chemotherapy-induced neutropenia in early-stage breast cancer
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Neutropenia is one of the most important dose-limiting toxicities and often the reason for dose reduction. In this study we aimed to assess whether chemotherapy-induced neutropenia could be a marker of efficacy and associate with increased survival. Data from a retrospective survey for early breast cancer patients in our hospital were reviewed. Three hundred and thirty-five patients who had been treated with six cycles of cyclophosphamide, epirubicin, and fluorouracil (CEF) were studied. The association between chemotherapy-induced neutropenia and overall survival (OS) was assessed. According to a multivariate Cox model with time-varying covariates, hazard ratios of death were 0.434 (95% confidence interval (CI), 0.298–0.634; P < 0.001) for patients with mild neutropenia, and 0.640 (95% CI, 0.42–0.975; P = 0.038) for those with severe neutropenia. Neutropenia occurring in early breast cancer patients is an independent predictor of increased survival. These findings suggest that neutropenia in patients who receive chemotherapy is strongly associated with a better prognosis.
KeywordsBreast cancer Adjuvant chemotherapy Neutropenia Prognosis Time-dependent variable
This study is supported by The Science Technology Development Project of Colleges and Universities in Tianjin  and Talented Professionals Scientific Research Funds of Tianjin Medical University Cancer Institute and Hospital. The authors would like to thank Yue Li, Hongmeng Zhao, Yanqun Song for their help with data collecting.
Conflict of interest
None of the authors has any competing interest to declare. The authors have no relevant financial interests to disclose.
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