Changes in White Blood Cells in Solid Cancers Before First Cycle and After the Third Cycle of Chemotherapy

Abstract

Introduction: Chemotherapy is a nonspecific drug that kills or damages fast growing cells; cancer cells and noncancerous body cells including white blood cells (WBCs). Changes to the WBCs can begin as early as few days to a week after starting chemotherapy treatment. This study was conducted to assess the effect of three cycles of chemotherapy on white blood cells compared to that at diagnosis of solid cancers. Methods: This is a prospective study included 100 patients diagnosed with solid cancers and subjected to chemotherapy in the National Cancer Centers in Aden and Taiz governorates, during 2020. Complete blood count was done for all patients prior to the first cycle and after the third cycle of chemotherapy. Results: The mean total WBCs count, absolute neutrophil count (ANC), absolute eosinophile count (AEC) and absolute monocyte count (AMC) were statistically significantly lower after third cycle when compared to that before first cycle. Meanwhile, the mean Absolute Lymphocyte count (ALC) and absolute basophile count (ABC) did not show any significant difference. Only 9.0% of solid cancer patients had leucocytosis at diagnosis. The percentage of patients with low WBCs count significantly increased after the third cycle, while the percentage of patients with normal WBCs count significantly decreased after the third cycle. The ANC showed a significant statistical difference between the counts prior to the first cycle of chemotherapy and after the third cycle of chemotherapy. Normal ANC was observed among 74.0% of patients before the first cycle of chemotherapy and it decreased to 53.0% after the third cycle. Neutropenia with all grades of severity was statistically significantly higher after the third cycle. The mean total WBCs count decreased after the third cycle in all types of cancers, and this decrease was statistically significant in patients with breast cancers and lymphomas, while other cancers did not show such significance Conclusion: This study concluded that in patients with solid cancer, WBCs and mainly the ANC significantly decreased after the third cycle of chemotherapy to a level that may be severe to affect patients’ overall health.