The incidence and risk factors of severe neutropenia and febrile neutropenia due to chemotherapy among gynecologic cancer patients in Thailand

Purpose: To investigate the incidence of chemotherapy-induced neutropenia and febrile neutropenia (FN) among patients with gynecologic cancer receiving initial chemotherapy and to determine associated risk factors related to neutropenia and FN. Materials and Methods: This retrospective study gathered the available record data of gynecologic cancer patients who received first-line chemotherapy from January 2012 to December 2015 at Siriraj Hospital,Thailand. All gynecologic cancer patients over the age of 18 and who had received initial chemotherapy were included. Results: Four hundred seven gynecologic cancer patients were included and there were 2,249 cycles of chemotherapy (17 regimens). Two hundred nine patients (52.0%) had severe neutropenia and 11 patients (2.7%) of 407 patients (2.7%) were diagnosed as FN. Carboplatin-containing regimens were the only one risk factor for severe neutropenia in the logistic analysis. Meanwhile, the use of myeloid growth factors for the prevention of FN could reduce the risk of FN (odd ratios 0.03; 95% confidence interval 0.005-0.231). Conclusion: The incidences of severe neutropenia and FN were 52.0% and 2.7%, respectively. It was also shown that myeloid growth factor use might act as a prevention among patient with intermediate risks of FN using cisplatin and doxorubicin.