Pretreatment haematological laboratory values predict for excessive myelosuppression in patients receiving adjuvant FEC chemotherapy for breast cancer

BACKGROUND: A predictive model that identifies patients at risk of excessive neutropenia following chemotherapy would be valuable in guiding the use of supportive therapies. PATIENTS AND METHODS: We conducted a retrospective analysis of 741 patients who had received adjuvant 5-fluorouracil, epirubicin, cyclophosphamide (FEC) chemotherapy for breast cancer. The cause of every schedule alteration was identified. The ability of pretreatment haematological indices to predict for excessive myelosuppression was assessed. RESULTS: Pretreatment absolute neutrophil count (ANC) and absolute lymphocyte count (ALC) were strongly associated with the risk of neutropenic events (NEs), febrile neutropenia (FN) or receiving suboptimal chemotherapy dose intensity (DI20% and would qualify for primary prophylaxis with granulocyte colony-stimulating factor support under current guidelines.