Profile of Chemotherapy-Indused-Severe Neutropenia and Associated Risk Factors among Cancer Patients at the Yaounde General Hospital

Background: Neutropenia is a spontaneous complication of chemotherapy. When severe, it is significantly associated with important infectious diseases that increase morbidity, mortality and the cost of management. Objective: determine the prevalence, incidence, frequency of severe neutropenia in cancer patients treated with chemotherapy and associated risk factors. Materials and Methods: This was a prospective and descriptive study conducted at the Yaounde General Hospital from January 2016 to December 2017. Neutrophil levels in blood were evaluated before and during chemotherapy treatment. These values were compared to the risk of severe neutropenia in the various subgroups of patients. Statistical analyses were performed using EPI software. Results: Two hundred and seventy-six patients were recruited, 54 were excluded. There were 594 cycles of chemotherapy treatment, ranging from 1 to 4 cycles, with an average of 2.6 cycles per patient. The prevalence of neutropenia before treatment was 19.56% with 0% severe neutropenia. The incidence of neutropenia during treatment was 25% with 22.34% of severe neutropenia (G3 = 16.30%; G4 = 6.04%). The overall frequency of neutropenia was 44.5%, we observed an association between severe neutropenia and lymphocyte count < 1000/mm3 (p value < 0.01), female sex (P = 0.04), chemotherapy (p = 0.01). Lymphopenia was the only independent risk factor (OR: 5.14, CI: 2.34 – 8.24). Conclusion: we suggest that lymphopenia < 1000/mm3 as well as Neutropenia 3 should be used as a threshold value below which chemotherapy should be contraindicated.