ASSESSMENT OF ABSOLUTE NEUTROPHIL COUNT AND CD4  LYMPHOCYTE COUNT IN ADULT CANCER PATIENTS ON  CHEMOTHERAPY

ANAZOEZE MADU

ANAZOEZE MADU National Postgrduate Medical College of Nigeria (NPMCN)

Abstract

A total of eighty patients with various malignancies seen between September
2008 and April 2009 at the University of Nigeria Teaching Hospital (UNTH)
Ituku-Ozalla Enugu Nigeria had their absolute neutrophil counts and CD4
lymphocyte counts done at Days 0 and 12 of the first cycle of their various
chemotherapeutic regimens. They were adult patients who had been diagnosed of
various malignancies, consisting of Breast cancer 36 cases (45%), Non-Hodgkin’s
lymphoma 8 cases (10%), Hodgkin’s lymphoma 13 cases (16.25%), Colorectal
carcinoma 6 cases (7.5%), Multiple myeloma 7 cases (8.75%), Cervical carcinoma
1 case (1.25%) and other malignancies 9 cases (11.25%). Manual counting of
absolute neutrophil count was done, while the CD4 lymphocyte count was done
using the Partec Cyflow ® 2000 CD4 cell counter. Some other haematological
indices; packed cell volume, blood haemoglobin concentration, white blood cell
count and platelet count were also determined. The socio -demographic data of the
patients were assessed from a questionnaire.
There were 27 males (33.75%) and 53 females (66.25%). The age of the
patients ranged from 18 to 80 years with a median of 45 years. The mean absolute
neutrophil count of the respondents pre- and post-chemotherapy was 3.7 ± 2.1 x
109/L and 2.5 ± 1.6 x 109/L respectively. The mean CD4 lymphocyte count pre-
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and post-chemotherapy was observed to be 593.98 ± 357.13 cells/L and 411.63 ±
223.88 cells/L respectively. There were significant differences in both the
absolute neutrophil count (p= 0.00) and CD4 lymphocyte counts (p=0.00) after
chemotherapy compared to the pre-chemotherapy values.
Chemotherapeutic combinations containing Cyclophosphamide and
Adriamycin were observed to cause significant reduction in absolute neutrophil
and CD4 lymphocyte counts. Haematological parameters which were found to be
significantly reduced include; haemoglobin concentration, packed cell volume and
white cell count.