The effects of cyclophosphamide, adriamycin and 5-fluorouracil chemotherapy on blood cells and cardiac hemodynamics in breast carcinoma patients: A case study at Dr. Kariadi general hospital, Semarang, Indonesia

Abstract

Background: One of the treatment modalities for breast malignancy is chemotherapy. Chemotherapy could kill cancer cells as well as normal cells, including blood cells and cardiac cells. Early detection of adverse events includes myelosuppression and cardiotoxicity could reduce morbidity and mortality rates. This study aims to determine a decrease in blood cells and cardiac hemodynamics in breast carcinoma patients who underwent Cyclophosphamide, Adriamycin, and 5-Fluorouracil (CAF) chemotherapy. Methods: Analytical prospective observational study with breast carcinoma. The measurements were Haemoglobin (Hb), Hematocrit (Ht), Erythrocyte (Ery), Leukocyte (Leu), Platelet (Plt), Left Ventricle Ejection Fraction (LVEF), Stroke Volume (SV), and Cardiac Output (CO) until 3rd cycles of chemotherapy. Data were analyzed using SPSS version 17 for Windows. Results: There were 35 subjects enrolled in this study. Decreases in Hb, Ht, Ery, Leu, and Plt after the 1st, 2nd, and 3rd cycles of chemotherapy were statistically significant (p<0.05). There was a statistically significant decrease in LVEF, SV, and CO after the 1st, 2rd and 3rd cycles of chemotherapy (p<0.05). Besides, the SV and CO after the 2nd and 3rd cycles of chemotherapy were also decreased significantly (p<0.05). Conclusions: There is a decrease in blood cells (Hb, Ht, Ery, Leu, Plt) and cardiac hemodynamics (LVEF, SV, and CO) in breast carcinoma patients who underwent CAF chemotherapy.