Changes in Blood Pictures, Urine Cytology and Renal Function in Breast Cancer Patients Treated with Cyclophosphamide in Radiation Isotope Center - Khartoum-RICK

Abstract

This study was carried out in Radiation Isotope Center, Khartoum during the period March – July 2011. The objective was to detect any abnormal change in urine composition and cytology, blood picture or renal function in ten breast cancer (BRC) patients receiving Cyclophosphamide treatment and compared to 20 normal control subjects receiving no treatment. Age of study subjects ranged from 25 – 55 year. 60% of BRC patients were above 45 year old. Eight BRC patients and 14 control subjects were married and had children who were all breast fed. Four patients and six control subjects had family history of breast cancer; history of ovarian and colon cancer was also recorded. Treatment was given in four treatment cycles (TC), each lasting for 21 days. Urinalysis and urine cytology was performed just before and six hours after each TC. Hematology, urea and creatinine were done once before each treatment. Urine of both BRC patients and control subjects contained pus cells and red blood cells. Their numbers increased slightly after each TC in BRC patients. Both Pap and Diff-quick stains were used for urine cytology and the latter was found superior. Cellularity of the urine sediment in BRC patients increased after TC1 and decreased at TC 2 and 3. Small number of leukocytes and few parabasal cells were seen and their number increased after each TC. Hemoglobin concentration decreased slightly after each TC but the values were within the normal range and were comparable to that of control subjects. Significant decrease in WBC and neutrophils counts was observed in BRC patients after each TC. Counts at TC 4 were about 65% and 36% of initial counts for WBC and neutrophils, respectively. This was associated with slight steady increase in lymphocyte counts. The white cell counts at cycle 1 were not largely different from that of control subjects. Mean urea and creatinine values showed no significant changes at each TC and the values were comparable to those of controls. It is concluded that Cyclophosphamide treatment does not seem to cause urinary tract infection, bladder abnormalities or neoplastic changes. However, leucopenia and neutropenia seem to be a consequence of treatment.