Does chemotherapy-induced neutropaenia result in a postponement of adjuvant or neoadjuvant regimens in breast cancer patients? Results of a retrospective analysis

In 2005, 224 patients received adjuvant/neoadjuvant chemotherapy for breast cancer in a single institution according to daily practices. Regimens consisted of epirubicin-based chemotherapy (FEC100, four or six cycles), or three cycles of FEC100 followed by three cycles of docetaxel. An absolute blood count was carried out every 3 weeks, 1–3 days before planned chemotherapy cycle. Overall, 1238 cycles were delivered. An absolute neutrophil count (ANC) <1.5 × 109 l−1 before planned chemotherapy was found in 171 cycles. Of these, 130 cycles (76%) were delivered as planned regardless of whether ANC levels recovered, and 41 (24%) were delayed. None of these patients developed a febrile neutropaenia. Haematopoietic support (granulocyte colony-stimulating factor (G-CSF)) was required in 12 cycles. We found that the majority of patients with an ANC <1.5 × 109 l−1 before planned chemotherapy received planned doses, without complications and need for G-CSF

Kind met buikpijn en rectaal bloedverlies

Van Leeuwen CD, Holtman GA, Kranenberg JJ. A girl with abdominal pain and rectal bleeding. Huisarts Wet 2015;58(1):42-4. Enterobius vermicularis, or threadworm, is not often considered in the differential diagnosis of abdominal pain and blood in faeces, but it is advisable not to ignore this diagnosis. While E. vermicularis infection is usually not harmful, in rare cases invasion of the intestinal mucosa can lead to more severe inflammatory signs, such as rectal bleeding. It is not clear under which conditions this common intestinal parasite invades the intestinal mucosa, but it seems that it makes its entry through existing injury or lesions. E. vermicularis infection can easily be treated, and preferably the entire family should be treated, to prevent re-infection.</p