P-291 - Significance of chemotherapy induced neutropenia as a prognostic factor in colorectal cancer patients

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Cytotoxic agents
Complications/Toxicities of treatment
Colon and Rectal Cancer
Biological therapy
Presenter J.S. An
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J.S. An, K.H. Kim
  • Ewha Womans University Medical Center, Seoul/KR



After chemotherapies, many patients have a experience of chemotherapy induced neutropenia. Chemotherapy induced neutropenia is generally known effect of bone marrow suppression. As an index of effective chemotherapy, neutropenia was considered as a good prognostic factor. We had doubts about neutropenia effect and analyzed 212 colorectal cancer patients.


In order to study neutropenia in colorectal cancer chemotherapy, we used data of colorectal cancer patients from an integrated Ewha Womans University medical center, colorectal department. With the use of Kaplan Meier Survival analysis and Cox regression, we analyzed 212 colorectal patients with stage II, III colon cancer who had radical operation and received 5FU-LV, FOLFOX, as adjuvant first-line chemotherapy. Neutropenia group was defied as absolute neutrophil count (ANC) below 1500/ul. We evaluated the associations between neutropenia and recurrence or death of colorectal cancer patients who were passed average 3.02 years after beginning chemotherapy.


We analyzed colon cancer patients who were treated with 5FU-LV, FOLFOX 4 as the first-line chemotherapy. Neutropenia group risk was 2.37 times higher than non-neutropenia group (95% CI 1.33-4.25, p = 0.004). After correction of chemotherapies, sex and age, the result was the same except the risk was higher than before correction. Non-neutropenia group's 3 year progression-free survival rate was 81.9%, and 5 year progression-free survival rate was 77.1%. Instead, neutropenia group 3 year progression-free survival rate was 61.9%, 5 year progression-free survival rate was 53.9%.


Consequently, neutropenia patients show higher death and recurrence rate. This implies that the bone marrow suppression leads poor general condition like febrile neutropenia including bacteremia or death.

Figure: P-291