Assessing the Value of Weekly Full Blood Counts in Patients with Gynecological Cancers Receiving Weekly Carboplatin/Paclitaxel Chemotherapy

Background: Dose dense carboplatin and paclitaxel regimens are increasingly being used to treat advanced serous gynaecological malignancies (ovary and uterus) in the adjuvant and relapse setting. The purpose of this study was to quantify the incidence of neutropenia and thrombocytopenia in patients receiving weekly Carboplatin and Paclitaxel (wCP) or Carboplatin q21 with weekly Paclitaxel (CwP) and more specifically the incidence of clinically significant myelosuppression – neutropenic sepsis or thrombocytopenia requiring intervention such as platelet transfusion. Our overall aim being to determine if routine blood counts are really necessary on days 8 and 15 of a wCP 21/28 day cycle or CwP 21 day cycle. Results: We analysed haematological data for 56 patients, 24 of whom had wCP and received 179 planned infusions and 32 of whom had CwP and received 407 planned infusions. The incidence of >G3 neutropenia in the group receiving wCP was 2.8% (5/179), the incidence of >G3 thrombocytopenia was 1.8% (3/179). Patients receiving CwP had an incidence of >G3 neutropenia and >G3 thrombocytopenia of 0.7% (3/407). Notably, there was only one case of febrile neutropenia, incidence of 0.2% (1/407). Conclusion: Gynaecological patients receiving either wCP or CwP regimens do not require routine full blood counts on day 8 and 15. This allows a more cost effective and efficient route of chemotherapy delivery for both patients and staff.