The relevance of macrocytosis induction during neoadjuvant dose-dense chemotherapy in breast cancer patients

• Published in: Anti-cancer drugs Vol. 33; no. 1; p. e655
• Main Authors: Boraska Jelavić, Tihana, Podrug, Mario, Ban, Marija, Belac Lovasić, Ingrid, Curić, Zvonimir, Vrdoljak, Eduard
• Format: Journal Article
• Language: English
• Published: England 01.01.2022
• Subjects: Adult; Aged; Anthracyclines - pharmacology; Anthracyclines - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - pharmacology; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Cyclophosphamide - pharmacology; Cyclophosphamide - therapeutic use; Disease-Free Survival; Erythrocytes - drug effects; Erythrocytes, Abnormal - drug effects; Female; Hematologic Tests; Humans; Middle Aged; Neoadjuvant Therapy - methods; Paclitaxel - pharmacology; Paclitaxel - therapeutic use; Retrospective Studies
• ISSN: 1473-5741
• DOI: 10.1097/CAD.0000000000001223

The aim of this study was to explore the red blood cell changes that occur during neoadjuvant dose-dense chemotherapy (NAC) of breast cancer. Also, we investigated the role of macrocytosis as a predictive biomarker for pathological complete response and disease-free survival (DFS) in these patients. A retrospective analysis of 82 breast cancer patients' data treated with anthracycline-cyclophosphamide-paclitaxel (AC-T) NAC in three oncology institutions in south Croatia from 2013 to 2020 was carried out. During chemotherapy mean corpuscular volume increased with time, with a median increase of 7.25 fl. Macrocytosis was induced in 38% of patients overall. Development of macrocytosis did not correlate with DFS [hazard ratio = 0.525; 95% confidence interval (CI), 0.074-3.768; P = 0.525]. Higher percentage of patients in macrocytosis group achieved PCR, 39% vs. 29% in no macrocytosis group, but this difference was not statistically significant. The relevance of macrocytosis induction during dose-dense neoadjuvant chemotherapy in breast cancer should be further explored.