Abstract: Objective To observe and analyze the related relationship of myelosuppression after chemotherapy for breast cancer. Methods A total of 120 breast cancer patients from the Breast Department of Guangdong Maternal and Child Health Hospital and the Oncology Department of Shaoyang Central Hospital from January 2022 to June 2023 were collected. The patients were divided into non-myelosuppression group （control group, n=20）, mild myelosuppression group （mild group, n=76）, and severe myelosuppression group （severe group, n=24） according to the situation of postoperative chemotherapy myelosuppression. The postoperative chemotherapy regimens for all patients were EC→T, AC or EC. The collected and preliminary analyzed data included the clinical characteristics of 120 patients, the univariate analysis of myelosuppression after chemotherapy in the three groups of patients, the relationship between postoperative chemotherapy myelosuppression and various adverse reactions, and the relationship between the degree of myelosuppression and the severity of adverse reactions. Results Among the 120 patients who underwent postoperative chemotherapy for breast cancer, 83.3% （100 cases） experienced varying degrees of myelosuppression, among which 76.0% （76 cases） were mild cases （grades Ⅰ and Ⅱ）, 20% （24 cases） were severe cases （grades Ⅲ and Ⅳ）, and 16.7% （20 cases） of the patients did not experience myelosuppression. No patient interrupted or reduced the dose of chemotherapy. The degree of myelosuppression was related to the patient′s age, chemotherapy regimen, nutritional status, and pre-chemotherapy combined with diabetes, and there were statistical significances between the patients in the control group, the mild myelotransplant group, and the severe myelosuppression group （all Ps were less than 0.05）. Among the seven adverse reaction symptoms counted, there was no statistical significance among the patients in the control group, the mild group, and the severe group （all Ps were more than 0.05）. According to the WHO adverse reaction classification standard, the distribution of adverse reaction grades after chemotherapy in patients with different degrees of myelosuppression was different. The more severe the degree of myelosuppression, the higher the grade of adverse reactions （P=0.001）. Conclusion Chemotherapy-induced myelosuppression was associated with patient age, chemotherapy regimen, nutritional status, and pre-chemotherapy comorbid diabetes mellitus; the proportion of chemotherapeutic toxicities occurring may not be related to the degree of myelosuppression, but was associated with the WHO grading of adverse effects.

Key words: breast cancer, myelosuppression, chemotherapy

摘要： 目的 观察及分析乳腺癌化疗后骨髓抑制的相关关系。方法 收集广东省妇幼保健院乳腺科及邵阳市中心医院肿瘤科2022年1月~2023年6月乳腺癌患者120例,根据术后化疗骨髓抑制的情况将患者分为无骨髓抑制组（对照组,n=20）、轻度骨髓抑制组（轻症组,n=76）和重度骨髓抑制组（重症组,n=24）,所有病人的术后化疗方案为EC→T、AC或EC方案。收集和初步分析的数据包括120例患者的临床特征、三组患者化疗后骨髓抑制的单因素分析、术后化疗后骨髓抑制与各不良反应关系以及不同程度骨髓抑制与不良反应严重程度关系。结果 120例乳腺癌术后化疗的患者中,83.3%（100例）的患者发生不同程度的骨髓抑制,其中76.0%（76例）为轻症（Ⅰ、Ⅱ级）,20%（24例）为重症（Ⅲ、Ⅳ级）,没有骨髓抑制的患者占16.7%（20例）。本组病例中没有中断化疗及减少剂量化疗的患者;骨髓抑制的程度与患者的年龄、化疗方案、营养状况以及化疗前合并糖尿病相关,对照组、轻症组及重症组患者间的差异有统计学意义（所有P<0.05）。在统计的7项不良反应症状中,对照组、轻症组及重症组患者间的差异没有统计学意义（所有P>0.05）。根据WHO不良反应分级标准,不同程度的骨髓抑制在患者化疗后不良反应分级的分布不同,骨髓抑制程度越严重,不良反应的分级越高（P=0.001）。结论 化疗导致的骨髓抑制与患者年龄、化疗方案、营养状况以及化疗前合并糖尿病相关;化疗毒性反应发生的比例与骨髓抑制程度可能无关,但与WHO不良反应的分级相关。

关键词: 乳腺癌, 骨髓抑制, 化疗