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The risk of amenorrhoea after adjuvant chemotherapy for early stage breast cancer is related to inter-individual variations in chemotherapy-induced leukocyte nadir in young patients: Data from the randomised SBG 2000-1 study
European Journal of Cancer, 10/14/09

Rosendahl M et al. – Amenorrhoea is a common side-effect to chemotherapy of premenopausal women. We examine the association between chemotherapy-induced leucopaenia and the development of amenorrhoea in premenopausal women with breast cancer. Age is the most important risk factor of amenorrhoea after FEC chemotherapy. However, for younger patients, lower leukocyte nadir in response to STANDARD FEC treatment or increased doses of C and E were associated with increased risk of amenorrhoea.

Methods

Multi-centre, randomised, controlled study
1016 premenopausal women received seven series of FEC (F: fluorouracil, E: epirubicin and C: cyclophosphamide) for early stage breast cancer
In first series, all patients received standard dose (F: 600mg/m2, E: 60mg/m2 and C: 600mg/m2)
Patients with leukocyte nadir 1.0–1.9×109/l continued with standard dose for remaining 6 series
Patients with leukocyte nadir 2×109/l randomised to standard or increased dose of E and C
After each series, leukocyte nadir evaluated

Results

Risk of amenorrhoea increased with age
Age-stratified analysis of STANDARD groups (equal dose, different initial leukocyte nadir) low leukocyte nadir associated with amenorrhoea for patients in age-group 25–39years
In age-stratified analysis in randomised groups (different doses, same initial leukocyte nadir) a dose related increased risk of amenorrhoea was found for age-groups 25–39 and 40–44years

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