Prevalence of Neutropenia in HIV-Infected Patients with Malignancy Receiving Chemotherapy or Radiotherapy
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Abstract
Background: Serious neutropenia is a common complication of chemotherapy and radiation among HIV-infected patients with malignancy leading to morbidities and deaths. This study was intended to investigate the prevalence and risk factors associated with neutropenia in HIV-infected patients with malignancy receiving chemotherapy and/or radiotherapy.
Methods: A retrospective cohort study was conducted by extensive reviewing patients’ medical records. Cancer patients with HIV infection who received medical attendances at Vajira hospital from January 1, 2013 to December 31, 2017 were participated. Clinical data including demographics, cancer types, stages and treatment, and HIV-related factors were collected and analyzed.
Results: There were 39 eligible patients, 20 had AIDS-defining cancers and 19 had non-AIDS-defining ones. The prevalence of all grade neutropenia was 58.9% (23 of 39). Slightly more common in females (61.5%). The median age was 50.53 (IQR 40.92-60.14). Median CD4 cell count prior to cancer diagnosis was 304.9 cells/μL (IQR 175 – 387). Nighty percent of lymphoma patients and all breast cancer patients developed neutropenia after chemotherapy. On the other hand, neutropenia did not occur among HIV-infected cancer patients receiving radiotherapy. Independent risk factors associated with neutropenia included those who aged more than 55 years and had hematologic malignancies. There was no statistically significant association with sex, body mass index, ECOG performance status, comorbidities, prophylactic treatment against opportunistic infection, CD4 count, HIV viral load, and specific type of anti-retroviral drugs.
Conclusion: The prevalence of neutropenia among cancer patients with HIV infection was 58.9%. Most occurred among patients with lymphoma and breast cancer.
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