Abstract:
Background: Chemotherapy-induced neutropenia is a frequent and potentially life-threatening complication that may lead to treatment delay, dose reduction, infection, and poor cancer outcomes. Evidence on the incidence and predictors of neutropenia among cancer patients in Ethiopia remains limited. This study aimed to determine the incidence and predictors of neutropenia among adult cancer patients receiving chemotherapy at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.
Methods: A retrospective cohort study was conducted among adult cancer patients who received chemotherapy between September 2015 and August 2021. Patients with neutropenia at baseline were excluded. Data were extracted from medical records using a structured checklist. Kaplan–Meier methods and log-rank tests were used to compare time-to-neutropenia across groups. Cox proportional hazards regression identified predictors of neutropenia, reported as adjusted hazard ratios (AHRs) with 95% confidence intervals (CIs).
Results: A total of 398 patients were included (79.7% female; median age 45 years), contributing 38,276 person-days of follow-up. The incidence density of neutropenia was 3.45 per 1,000 person-days (95% CI: 2.91–4.09), with a cumulative incidence of 33.2%. Among cases, 68.2% were mild, 25.8% moderate, and 6.1% severe neutropenia. In multivariable analysis, age ≥65 years (AHR = 1.43; 95% CI: 1.02–2.53), cigarette smoking (AHR = 3.34; 95% CI: 1.34–8.38), cervical cancer (AHR = 3.35; 95% CI: 1.22–9.24) and head-and-neck cancer (AHR = 5.56; 95% CI: 1.67–18.49) compared with lung cancer, and adjuvant treatment intent (AHR = 1.86; 95% CI: 1.03–3.35) were significant predictors of neutropenia.
Conclusion: Neutropenia occurred in one-third of adult cancer patients receiving chemotherapy at the University of Gondar hospital. Older age, smoking, cancer type, and adjuvant therapy were key predictors. Strengthening early risk assessment, close monitoring, and preventive strategies such as patient education and timely supportive care may reduce neutropenia-related complications in Ethiopian oncology settings.
Keywords: Chemotherapy-induced neutropenia; cancer; incidence; predictors; Ethiopia; oncology.
