Background:

Paclitaxel increases survival in breast cancer. Weekly application is the best tolerated and most effective. One in 5 patients will have neutropenia and one in 15 patients will develop febrile neutropenia. The objective was to identify risk factors for the development of grade III-IV neutropenia.

Material and methods:

We retrospectively analyzed 257 patients who used weekly paclitaxel and had blood biometry before the weekly infusion for 12 weeks. We determined age, clinical stage, comorbidity, body mass index, weekly total infused dose, dose/m2 of body surface, number of medical consultations, visits to the emergency room and hospitalizations.

Results:

A total of 118 patients (45.9%) received neoadjuvant paclitaxel, adjuvant 86 (33.4%) and 53 first-line palliative therapy (20.6%). The frequency of neutropenia grade III-IV was 5.9%. The multivariate analysis identified as independent factors for neutropenia grade III-IV: age (over 60 years) (OR: 3.11; CI 95%: 1.05-9.20; p = 0.04), previous chemotherapy (OR: 3.74; CI 95%: 1.15-12.1; p = 0.027), being hypertensive (OR: 6.63; CI 95%: 2.18-20.15; p = 0.001).

Conclusions:

In patients older than 60 years, exposition to previous chemotherapy and some comorbidities, particularly hypertension, are risk factors for the development of grade III-IV neutropenia. The low incidence of grade III-IV neutropenia in daily clinical practice during weekly paclitaxel suggests a reconsideration of the weekly evaluation with blood biometry in patients without risk factors.

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