FACTORS ASSOCIATED WITH CHEMOTHERAPY-INDUCED NEUTROPENIA IN PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES AT DR GEORGE MUKHARI ACADEMIC HOSPITAL, PRETORIA, SOUTH AFRICA Key Words: Neutropenia, Febrile Neutropenia, Chemotherapy-induced neutropenia, Myelosuppression
FACTORS ASSOCIATED WITH CHEMOTHERAPY-INDUCED NEUTROPENIA IN PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES AT DR GEORGE MUKHARI ACADEMIC HOSPITAL, PRETORIA, SOUTH AFRICA
Key Words: Neutropenia, Febrile Neutropenia, Chemotherapy-induced neutropenia,
Myelosuppression
ACKNOWLEDGMENTS
? Professor OA. Towobola, my supervisor and statistician.
? Dr N. Mutidja of the Department of Internal Medicine (MEDUNSA) and Haematology Unit.
? Dr Manda?s sponsors: World Health Organisation (WHO) and the Zambian government.
? The nursing staff of the Haematology Unit at Dr George Mukhari Academic Hospital.
LIST OF TABLES
TABLE NUMBER PAGE
Table 1: Causes of neutropenia????????????????????.4
Table 2: Drugs used in the treatment of leukaemia and lymphoma?????10
Table 3: Grading of neutropenia????????????????????18
Table 4: MASCC index score for identifying low risk FN patients…………………..21
Table 5: Chemotherapy regimens used in the study ???????????.27
Table 6: Physical characteristics of the patients???????????.??36
Table 7: Baseline haematological indices of patients??????????.?37
Table 8: Chemotherapy regimens and number of patients treated in the study39
Table 9: CHOP regimen (3 weekly cycle)????????????????.41
Table 10: ABVD-P regimen (3 weekly cycle)???????????????..41
Table 11: Chemotherapy regimen mostly associated with severe CIN????..49
Table 12: Types of co-morbidities among patients?????????????50
Table 13: Association of CIN with patients physical and laboratory variables…..52
Table 14: Association of CIN with gender…………………………………………………….53
Table 15: Association of CIN with co-morbidities?????????????..54
Table 16: Association of CIN with HIV infection??????????????55
Table 17: ECOG performance status scale?????…?????????.?63
Table 18: Karnofsky performance scale?……………………………………………………66
Table 19: Guidelines for RBC transfusion?????????????????84
LIST OF FIGURES
FIGURE NUMBER PAGE
Figure 1: Age distribution of the patients (years)?????????????..35
Figure 2: Gender distribution of the patients ??????????????…35
Figure 3: Types of malignancies among patients ?????????????38
Figure 4: Degree of neutropenia associated with CVAD??????????47
Figure 5: Degree of neutropeni
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