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Cancer Chemotherapy and Pharmacology

07-02-2024 | Neutropenia | Original Article

Effect of lithium on chemotherapy-induced neutropenia in Egyptian breast cancer patients; a prospective clinical study

Authors: Ahmed O. ELKasar, Fatma Z. Hussien, Hala E. Abdel-Hamied, Ibrahim G. Saleh, Elsayed M. Mahgoup, Amr A. El-Arabey, Adel R. Abd-Allah

Published in: Cancer Chemotherapy and Pharmacology

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Abstract

Purpose

Myelosuppressive chemotherapy-induced neutropenia (CIN) remains a major limitation of cancer treatment efficacy, necessitating very expensive supportive care. Lithium carbonate, an inexpensive drug, can increase the number of neutrophils, possibly providing an efficacious and cost-effective alternative for treating CIN. The aim of this study was to determine whether lithium therapy can attenuate chemotherapy-induced neutropenia and leukopenia in breast cancer patients.

Methods

A total of 50 breast cancer patients were enrolled in this prospective, interventional, randomized, controlled, and single-blind study. The patients were divided into two groups: a control group (group 1, N = 25 patients) and a lithium-treated (treatment) group (group 2, N = 25 patients). Group 1 patients were further subclassified into a non-neutropenic control group (N = 16) and a neutropenic control (N = 9) based on the subsequent development of severe neutropenia, or not. The control group received 4 cycles of doxorubicin or epirubicin plus cyclophosphamide followed by 2 cycles of paclitaxel. The treatment group received the same regimen as the control group as well as oral lithium carbonate throughout the chemotherapy cycles.

Results

The results showed that the absolute neutrophil count (ANC) was increased in the lithium-treated group, while it was markedly reduced in both the non-neutropenic and neutropenic control groups (by 55.56% and 65.42% post-4 chemotherapy cycles, and by 19.57% and 39.90% post-6 cycles, respectively). The same pattern of alterations was observed for the total white blood cell count in both the control and treatment groups. In addition, the incidence and period prevalence were greatly reduced in the lithium-treated group compared to non-neutropenic and neutropenic control groups.

Conclusion

Lithium therapy ameliorated chemotherapy-induced leukopenia and neutropenia in breast cancer patients. This may provide a new strategy for cost-effective treatment of CIN, particularly in Egyptian cancer patients.
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Metadata
Title
Effect of lithium on chemotherapy-induced neutropenia in Egyptian breast cancer patients; a prospective clinical study
Authors
Ahmed O. ELKasar
Fatma Z. Hussien
Hala E. Abdel-Hamied
Ibrahim G. Saleh
Elsayed M. Mahgoup
Amr A. El-Arabey
Adel R. Abd-Allah
Publication date
07-02-2024
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-023-04620-w
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