Evaluation of Hematological Parameters Pre and Post Chemotherapy in Breast Cancer Patients at the National Cancer Institute in Sudan at Khartoum state, Sudan

Abstract

Introduction: Breast cancer is the most common malignancy among women worldwide, including in Sudan. Chemotherapy, a primary treatment modality, often results in hematological toxicity, impacting patients' overall health and treatment efficacy. This study aims to evaluate the changes in hematological parameters in breast cancer patients before and after chemotherapy in the Sudanese population. Materials and Methods: A case control study was conducted at the National Cancer Institute in Sudan at Khartoum state, Sudan. During the period of June 2022 to December 2022. A total of one hundred (N=100) female breast cancer patients scheduled for chemotherapy were enrolled.50 sample before initiation chemotherapy, and fifty (50) samples after first cycle of chemotherapy from same patients. And fifty (50) samples from the healthy individuals as control group. Venous blood was obtained, then CBC determined using hematology analyzer (Sysmex: XP-300). Hematological parameters, including Red blood cell count (RBC), white blood cell (WBC) count, and platelet count, and differential counts, were measured before the initiation of chemotherapy and after the completion of the first cycle. Data were analyzed using paired t-tests to determine the significance of changes in these parameters. Results: Significant reductions were observed in RBC levels (mean pre-chemotherapy: (3.8± 1.1) g/dL, mean post-chemotherapy: (2.1± 1.1); p<0.001) and WBC counts (mean pre-chemotherapy: 13.9 ± 1.9 x 10^3/μL, mean post-chemotherapy: 4.1 ± 1.9 x 10^3/μL; p<0.001). Platelet counts also decreased significantly (mean pre-chemotherapy: 661.8 ± 128.5 x 10^3/μL, mean post-chemotherapy: 182.4 ± 125.5 x 10^3/μL; p<0.01). Breast cancer patients before initiation the first cycle of chemotherapy show significant low in RBCs count (3.8 ± 1.1) when compared with control group (4.8 ± 0.4) (p = 0.000). Also, significant high in WBCS count (13.9 ± 1.9) when compared with control group (5.9 ± 1.3) (p = 0.000) and high PLTs count (661.8 ± 128.5) when compared with control group (262.7 ± 73.4) (p =0.000). And decrease in three parameters (pancytopenia) RBCs, WBCS, and PLTs count (2.7 ± 0.7) (4.1 ± 2.3) (182.4 ± 102.4) respectively when compared with control group (4.8 ± 0.4) (5.9 ± 1.3) (262.7 ± 73.4) (p =0.000) to all, when start the first cycle of chemotherapy. Conclusion: Chemotherapy in breast cancer patients leads to significant hematological changes, predominantly anemia, leukopenia, and thrombocytopenia. These findings underscore the need for close monitoring of hematological parameters during chemotherapy to manage potential toxicities and optimize treatment outcomes for breast cancer patients in Sudan.