Differences on the count of blood cells in pre-chemotherapy and post chemotherapy of patient with cancer in northern Ethiopia 2022, a longitudinal study

Differences on the count of blood cells in pre-chemotherapy and post chemotherapy of patient with cancer in northern Ethiopia 2022, a longitudinal study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Differences on the count of blood cells in pre-chemotherapy and post chemotherapy of patient with cancer in northern Ethiopia 2022, a longitudinal study Tadele Derbew Kassie, Bayu Wondimneh Yimenu, Gelagay Baye Temesgen, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4963614/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Cancer is a disorder involving uncontrolled growing cells that have the ability to invade and spread to other areas of the body. Drugs for chemotherapy cause damage to non-cancer cells and leads to low count of blood cells. There are controversial findings on the difference of the count on blood cell types. Studies are limited on the count of blood cell type before and after chemotherapy. Therefore, this study aimed to address this gap. Method : Institutional based longitudinal study design was done on 354 patients to compare blood cell types profile in pre and post-operative from September1, 2022 to October 1, 2022. Data extraction format was used to collection data source. To assure data quality, first data were entered and cleaned to epidata version 4.6 then exported to SPSS version 23 for analysis. Paired t-test was used to analysis data. Result: data was collected from 354 patients. The mean age of the respondent was 41.26 (±16.67). In the first diagnosis, nearly all of them reached stage III 167 (47%) and stage IV 159 (45%). All profiles of blood cell type showed decrement in post chemotherapy compared to pre-chemotherapy. The mean decrement of platelet is 23. 51×10 3 cells/mm 3 (p=0.001), red blood cell is 0.63×10 6 cells/mm 3 (p=0.08) and white blood cell is 2.49 ×10 6 cells/mm 3 (p=0.012) respectively. Conclusion: After chemotherapy, all profiles of blood cells count decreased. This means chemotherapy had significant effect on the number of all type of blood cells. blood cell type chemotherapy differences patient with cancer northern Ethiopia Introduction A disorder called cancer involves uncontrollably growing cells that have the ability to invade and spread to other areas of the body. There are numerous potential reasons for this, including an individual's genetic, environmental, or constitutional traits ( 1 ). Cancer is the most serious and deadly illness of the twenty-first century ( 2 ). The variety and location of the cancer, the conventional medical procedures and treatment protocols in the client's culture, and the its stage at the initial diagnosis all influence the cancer treatment that a patient receives. Treatment for cancer might involve a variety of approaches, including radiation therapy, chemotherapy, and surgery. Yet, patients are at risk for a number of adverse effects and these treatments are typically not curative. As a result, any cancer medication treatment has a number of side effects, including anemia, infection, bleeding issues, nausea, vomiting, allergic reactions, pain, soreness, constipation or diarrhea, hair loss, sore mouth, increased energy, and trouble falling asleep ( 3 ). According to the study done on the effect of chemotherapy and radiotherapy on red blood cells and hemoglobin in cancer patients, there was the difference of the level red blood cells in pre-chemotherapy and post chemotherapy ( 4 ). Administration of drugs for chemotherapy cause damage to non-cancer cells and this leads to low count of white blood cells following chemotherapy ( 5 ). Chemotherapies affect the numbers of blood cells and biochemical profiles in different ways. Chemotherapies function as alkalizing chemicals and cause the bone marrow's hematopoietic stem cells to disappear gradually ( 6 ). Chemotherapy usually works by blocking the creation of deoxyribonucleic acid (DNA), proteins, and microtubules, which results in the death of cells or the prevention of their proliferation ( 7 ). Chemotherapeutic drugs cause DNA damage during replication by covalently binding to the DNA of bone marrow cells to generate intra- and inter-strand cross-links. Platelets, leukocytes, and hemoglobin levels all drop ( 8 ). A study done on the effect of chemotherapy on hemoglobin revealed that there was no any significant association hemoglobin and chemotherapy ( 9 ). Chemotherapy-treated cancer patients have been shown to experience immune system changes and anemia. Frequent, intense chemotherapy has been shown to decrease immune cells that lead to opportunistic infections ( 10 ). Chemotherapy side effects are noticeable in the bone marrow, a key source of pluripotent hematopoietic stem cells ( 11 ). Moreover, the use of drugs that are specifically made to be cytotoxic in the complicated field of cancer treatment invariably has detrimental effects on blood cells profile. Many of these medications are mostly metabolized in the liver, therefore while administering chemotherapy, liver-drug interactions need to be taken into consideration ( 12 ). Chemotherapy administration presents a challenge to the careful control and equilibrium of liver function. Because of the liver's easy absorption of the majority of chemotherapy medicines, up to 85% of patients experience liver stenosis ( 12 ). Chemotherapy administered repeatedly can cause permanent damage to the liver by drawing in inflammatory cells and changing the levels of enzymes such as lactate dehydrogenase (LDH), ALT, AST, and alkaline phosphatase (ALP) and it can leads to decrease of erythropoietin( 13 ). The volume of platelet count after chemotherapy of patient with cancer showed decrement due to the effect of chemotherapy. However, studies done on ovarian cancer showed that there was increment of thrombocytes.( 14 ) There are controversial findings on the difference of the count on blood cell types on different studies. Most studies focused on the relationship between specific cancer type and single blood cell type. Studies are limited on the count of blood cell type before and after chemotherapy of patients with different cancer conditions in the specified areas. Knowing on the changes of blood cell type profiles is substantial for taking appropriate interventions. Therefore, this study aimed to address this gap and provide different scientific bases for various stakeholders. Methods This study was done in Mekele comprehensive specialized hospital, northern part of Ethiopia. The hospital has two-oncology center. These oncology centers were pediatric oncology center and adult oncology center. Study design To compare blood cells type count difference in pre-operative and post-operative patients with cancer, an institutional based follow up study design was used from september1, 2022 to October 1, 2022. Populations All patients with all type of cancer attended the hospital for chemotherapy were source populations and patients who started chemotherapy treatment from September 2018 to September 2022 were study populations. Inclusion and exclusion criteria Inclusion criteria All type of cancer patient who had complete medical record such as demographic record, stage of cancer, all type of blood cells counts were included in the study. Exclusion criteria Those patients with comorbid conditions Patients who lose follow up before completing cycle IV treatment were excluded from the study Sampling method and sample size determination All samples that fulfill the inclusion criteria were taken. The total samples were 354 samples. The required data were selected from these 354 samples, which were admitted in the oncology unit from September 2018 to september2022. Operation terms Pre-chemotherapy level of blood cell type : this is the level of blood cells at the time of diagnosis and before starting chemotherapy. Post-chemotherapy level of blood cell type : this is the level of blood cells after finishing the phase four treatment of chemotherapy Variables of the study Independent variable Chemotherapy is independent variable Dependent variable Type of blood cells such as red blood cell, white blood cells and platelets Data collection tools Data extraction format was used to collection the required information from secondary data source. So as to collect the required information the first the register log book was reviewed and we took the patients’ medical registration number, and the redundancy of MRN were removed by using excel. Finally, data were collection from smart care and patient individual folder. Method of data processing and analysis First data were entered and cleaned to epidata version 4.6. After that data was exported to SPSS version 23 for analysis. The level of the type of blood cell changes after and before chemotherapy was compared by using paired t-test. All assumptions of the test was done. Data quality control First data preparation checklist was adapted from different articles. The prepared checklist format was tested on 50 samples first before going to the actual data collection. The aim of the study was briefly explained to data collectors. The data collectors were one nurse from oncology unit, one smart care administrator and the other is one from card room workers. One day raining was given to these data collectors. The daily inspection how to fill the checklist was supervised. Results Sociodemographic characteristics of the patient Data were collected from 354 patients with all type of cancer before and after phase IV chemotherapy were taken from September 2018 to September 2022. The number of female and male were 215 (60.7%) and 139 (39.3%) respectively (table1). The mean age of the respondent was 41.26 (±16.67). Table1. Age and sex of the patient with cancer at oncology center of Mekele comprehensive and Age category in years Sex of the respondents Total Male Female 1-18 Frequency 20 9 29 % with the age group 69.0% 31.0% 100.0% % with the sex group 14.4% 4.2% 8.2% 19-30 Frequency 29 42 71 % with the age group 40.8% 59.2% 100.0% % with the sex group 20.9% 19.5% 20.1% 31-45 Frequency 27 90 117 % with the age group 23.1% 79.9% 100.0% % with the sex group 19.4% 41.9% 33.1% 46-65 Frequency 63 74 137 % with the age group 46.0% 54.0% 100.0% % with the sex group 45.3% 34.4% 38.7% Total Frequency 139 215 354 % with the age group 39.3% 60.7 100.0% % with the sex group 100.0% 100.0% 100.0% Type of cancer among the participant of the study Among the total patients the leading type of cancer are breast cancer 133 (37.6%), lymphoma 89 (25.1%) and sarcoma 36 (10.2%) respectively (table 2). At the time of first contact nearly all of them reached stage III and stage IV with 167 (47%) and 159 (45%) respectively. Table 2.Type of cancer among patient with cancer at oncology center of Mekele comprehensive and specialized hospital in2022 Frequency Percent Cumulative Type of cancer Breast cancer 133 37.5 37.6 lymphoma 89 25.1 62.7 Sarcoma 36 10.2 72.9 Colon cancer 23 6.5 79.4 Stomach cancer 4 1.1 80.5 Lung cancer 8 2.3 82.8 Rectal cancer 15 4.2 87 leukemia 7 2.0 89 Bone cancer 3 0.8 89.8 Others 36 10.2 100.0 Total 354 100.0 Difference of the count of blood cell type in pre-chemotherapy and post-chemotherapy among patients with cancer The profile of blood cell type before and after chemotherapy is shown in the table 3. Three type of blood cells namely red blood cells, white blood cells and platelets were measured at the time of diagnosis and after phase IV of chemotherapy. The mean value of red blood cells and white blood cell were measured using cells per mm 3 ×10 6 . The mean values of platelets were also measured by using cell mm 3 ×10 3 (table 3). Table3. Comparison of the level of blood cell type between pre-chemotherapy and post chemotherapy in Mekele comprehensive and specialized hospital in 2020 pairs Measure of blood cells pre and post Chemotherapy mean Mean Paired difference 95% CI of mean differences t df p-value Lower Upper Pair1 Red blood cell pre-chemotherapy Red blood cell post-chemotherapy 4.90 4.27 0.63 0.17 1.10 2.67 353 0.008 Pair2 white blood cell pre-chemotherapy white blood cell post-chemotherapy 10.99 8.50 2.49 0.55 4.44 2.52 353 0.012 Pair3 Platelet pre-chemotherapy Platelet post-chemotherapy 316.82 293.30 23.51 9.57 37.47 3.31 353 0.001 As shown from the above table3, all profiles of blood cell type showed decrement in post chemotherapy compared to pre-chemotherapy. The mean decrement of platelet is 23.51 ×10 3 cells/mm 3 (p=0.001), red blood cell is 0.63×10 6 cells/mm 3 (p=0.08) and white blood cell is 2.49 ×10 6 cells/mm 3 (p=0.012) respectively. Discussion Treatment for cancer has dis advantage on normal blood cell types. The drugs given for this treatment are cytotoxic on active cells (4, 15, 16). Cancer cells are normal, healthy and can multiply and the disadvantage of chemotherapy drugs occur when these drugs disrupt the normal function and multiplication of the cells healthy cells (17). Cancer patients who had been undergone in chemotherapy faced substantially life-threating complications like low in hemoglobin level and reduction of white blood cells. This led to anemia and exposure of different infections (11). In this follow up study, the paired mean value of blood cell types among patients in pre-chemotherapy and post chemotherapy were measured. The result of this study revealed that the counts mean value of red blood cells was reduced in post-chemotherapy compared to pre-chemotherapy. This study is in lined with the study done on the effect of chemotherapy and radiotherapy on red blood cells and hemoglobin in cancer patient (4). This suppression of red blood cells might be because chemotherapy suppressed the bone marrow, which produces normal and active red blood cells (2). The other explanation for this reduction is, many drugs that are used for treating cancerous cells damage the normal red blood cells. Therefore, the reduction of red blood cells leads to reduction of hemoglobin and hematocrit. The erythropoiesis production may be compromised because of chemotherapy and this disruption led to reduction of red blood cells. Drugs of chemotherapy also induce renal toxicity. Nephrotoxic drugs that are taken for chemotherapy significantly disrupt erythropoietin production. The other reason for this decrement may be erythropoietin reduction. The number of platelet count in this study reported as presence of huge difference between pre-chemotherapy and post-chemotherapy in patients with cancer. The difference may be happed to the reason that hormones produced in the kidney and liver to produce platelets disrupted by chemotherapy (18, 19). The number of platelet count in post chemotherapy compared to pre-chemotherapy is high. This study is opposite to the study of meta-analysis done on ovarian (14). This difference may happen because this study included all type of cancer and the mentioned article was done on only ovarian cancer. According to the result of this study, the number of white blood cell count decreased after chemotherapy compared to pre-chemotherapy (20, 21). This similarity may be happened to the fact that the given drugs for chemotherapy were similar. The other for this consistency result is that chemotherapy has cytotoxic effect to disrupt the normal production of white blood cells. Strength and limitation of the study Strength All type of cancer patient were include in the study Limitation Since data was from secondary source some data were not registered Other biochemical profiles were not considered Changes from phase to phase are not compared Conclusion and recommendations All blood cells namely red blood cells, white blood cells and platelets had decreased in their number among patients with Chemotherapy. As the result of this study showed the decrement of all cells is significant. As a result it would be best recommended to replace the decrements of blood cells during chemotherapy. Declarations Ethical approval and consent to participate Ethical clearance for this study obtained from Debre Markos University College of medicine and health science. Consent to participant Since data for this study was taken from secondary source, direct consent was not taken Ethics and consent to participate Not applicable Consent for publication Not applicable Authors contributions Tadele Derbew Kassie and Ayisheshm Asnake Abneh write the proposal, analysis data and write the original draft and edit the final document, Bayu Wondimneh Yimenu,Gelagay Baye Temesgen and Rahel Asres Shimelash, Ayisheshim Asnake Abneh excut data,conceptualization and write the document, Acknowledgment First, we would like to express our gratitude to the almighty God. Second, we would also thank to Debre Markos College of medicine and health science research and community service office to support us in technical assistances. Data Availability At any time, the corresponding author is responsible to give any additional resource when requested. Conflicting Interests The authors declared that there is no potential conflict of interest with respect to the research, authorship and publication of this article. Funding The author declared that there is no funding for this research article. References Lodish HF. Molecular cell biology: Macmillan; 2008. Gebremeskel G, Baye G. Bayu Wondimneh Sathisha Anekere Dasappa Setty 2 Gebrekidan Gebregzabher Asfeha 2 Ezra Belay 2. Cancer Management and Research. 2021;13:625-32. Aziz HA, Habeeb JM. Study the Effect of Chemotherapy on Some Hematological and Biochemical Parameters of Cancer Patients in AL-Muthanna Province, Iraq. Indian Journal of Public Health Research & Development. 2019;10(2). Younis M, Iqbal M, Shoukat N, Nawaz B, Watto F, Shahzad KA. Effect of chemotherapy and radiotherapy on red blood cells and haemoglobin in cancer patients. Sci Lett. 2014;2(1):15-8. Lowenthal RM, Eaton K. Toxicity of chemotherapy. Hematology/Oncology Clinics. 1996;10(4):967-90. Xuequan C, Langxiao T. The New Reform of China's Lay Assessor System. China Legal Sci. 2020;8:3. Padma R, Sundaresan S. Haematological and biochemical changes in pre and post-treatment of buccal mucosa carcinoma patients. Int J PharmSci Res. 2016;7(7):3002-6. Kaplan BW PDPmfEatw, background Aphatiuo, Ther. pwbWKbpC, 2013;(April):5–62. Wei Y-S, Zhou Y-G, Wang G-Y, Liang Z-H, Luo M-R, Yang T-A, et al. The impact of chemotherapy-associated hemoglobin on prognosis of colorectal cancer patients receiving adjuvant chemotherapy. Cancer Biomarkers. 2017;20(4):627-35. Medrano-Casique N, Tong HY, Borobia AM, Carcas AJ, Frías J, Ramírez E. Nonchemotherapy drug-induced agranulocytosis in children detected by a prospective pharmacovigilance program. Pediatric Hematology and Oncology. 2016;33(7-8):441-56. Siena S, Secondino S, Giannetta L, Carminati O, Pedrazzoli P. Optimising management of neutropenia and anaemia in cancer chemotherapy—advances in cytokine therapy. Critical reviews in oncology/hematology. 2003;48:S39-S47. Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours: John Wiley & Sons; 2011. Network N. Cancer-and Induced Anemia. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). 2018:1-51. Eggemann H, Ehricke J, Ignatov T, Fettke F, Semczuk A, Costa S, et al. Platelet count after chemotherapy is a predictor for outcome for ovarian cancer patients. Cancer Investigation. 2015;33(5):193-6. Nowrousian M, Waschke S, Bojko P, Welt A, Schuett P, Ebeling P, et al. Impact of chemotherapy regimen and hematopoietic growth factor on mobilization and collection of peripheral blood stem cells in cancer patients. Annals of oncology. 2003;14:i29-i36. Aldarouish M, Su X, Qiao J, Gao C, Chen Y, Dai A, et al. Immunomodulatory effects of chemotherapy on blood lymphocytes and survival of patients with advanced non-small cell lung cancer. International journal of immunopathology and pharmacology. 2019;33:2058738419839592. Noviyani R, Indrayathi PA, Budiana IG, Niruri R, Tunas K, Adnyani NDD. Effect of paclitaxel-cisplatin chemotherapy towards hemoglobin, platelet, and leukocyte levels in epithelial ovarian cancer patients. Journal of Applied Pharmaceutical Science. 2019;9(1):104-7. Ferroni P, Guadagni F, Riondino S, Portarena I, Mariotti S, La Farina F, et al. Evaluation of mean platelet volume as a predictive marker for cancer-associated venous thromboembolism during chemotherapy. Haematologica. 2014;99(10):1638. Bessman D. Prediction of platelet production during chemotherapy of acute leukemia. American Journal of Hematology. 1982;13(3):219-27. Han HS, Rybicki LA, Thiel K, Kalaycio ME, Sobecks R, Advani A, et al. White blood cell count nadir following remission induction chemotherapy is predictive of outcome in older adults with acute myeloid leukemia. Leukemia & lymphoma. 2007;48(8):1561-8. Ribeiro R, Broniscer A, Rivera G, Hancock M, Raimondi S, Sandlund J, et al. Philadelphia chromosome-positive acute lymphoblastic leukemia in children: durable responses to chemotherapy associated with low initial white blood cell counts. Leukemia. 1997;11(9):1493-6. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4963614","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":346150639,"identity":"8d4d271c-81da-42b2-ba7c-3e8804aceb37","order_by":0,"name":"Tadele Derbew Kassie","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYHACA4YHDMwMDBJA5gcgZmMnoJ4HpCUBqoVxBkgLMylamHlAQoS02LMf3vggocJaznx28zFpm1/b5PmYGRg/fMzBYwtPWrFBwpl0Y5k7x9Kkc/tuG7YxMzBLztyGz2E5ZhKJbYcTZ0jkmN3O7bnNCNTCxsyLTwv/G/Mfif8O18+QyP9227Lntj1hLUDDGRIbDidISOSw3Wb4cTuRsJYbz4olEo6lG86QOWb+s7fhdnIbM2MzXr+w9ydv/PChxlpeQrr5scGPP7dt57c3H/zwEY8WVMDYBiYbiFUPAn9IUTwKRsEoGAUjBQAAReNOgQ7HKNwAAAAASUVORK5CYII=","orcid":"","institution":"Debre Markos University","correspondingAuthor":true,"prefix":"","firstName":"Tadele","middleName":"Derbew","lastName":"Kassie","suffix":""},{"id":346150640,"identity":"10de7792-3931-4584-bfd8-9b497cdc3767","order_by":1,"name":"Bayu Wondimneh Yimenu","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Bayu","middleName":"Wondimneh","lastName":"Yimenu","suffix":""},{"id":346150643,"identity":"27e91c78-0b07-4d99-b6ba-f48105a45d86","order_by":2,"name":"Gelagay Baye Temesgen","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Gelagay","middleName":"Baye","lastName":"Temesgen","suffix":""},{"id":346150646,"identity":"a2ce9126-4523-4efa-aade-3d8d72f6f559","order_by":3,"name":"Rahel Asres Shimelash","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Rahel","middleName":"Asres","lastName":"Shimelash","suffix":""},{"id":346150648,"identity":"aaa88100-5d2a-4841-b03b-8cb169a85618","order_by":4,"name":"Ayisheshim Asnake Abneh","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Ayisheshim","middleName":"Asnake","lastName":"Abneh","suffix":""}],"badges":[],"createdAt":"2024-08-23 10:39:48","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4963614/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4963614/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":74911874,"identity":"92303b91-22d1-4602-a5e5-14c8e32d72a6","added_by":"auto","created_at":"2025-01-28 09:17:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":811961,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4963614/v1/1564dcc7-6e97-4798-b6a1-ff79ddd177f6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Differences on the count of blood cells in pre-chemotherapy and post chemotherapy of patient with cancer in northern Ethiopia 2022, a longitudinal study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eA disorder called cancer involves uncontrollably growing cells that have the ability to invade and spread to other areas of the body. There are numerous potential reasons for this, including an individual's genetic, environmental, or constitutional traits (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Cancer is the most serious and deadly illness of the twenty-first century (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). The variety and location of the cancer, the conventional medical procedures and treatment protocols in the client's culture, and the its stage at the initial diagnosis all influence the cancer treatment that a patient receives. Treatment for cancer might involve a variety of approaches, including radiation therapy, chemotherapy, and surgery. Yet, patients are at risk for a number of adverse effects and these treatments are typically not curative. As a result, any cancer medication treatment has a number of side effects, including anemia, infection, bleeding issues, nausea, vomiting, allergic reactions, pain, soreness, constipation or diarrhea, hair loss, sore mouth, increased energy, and trouble falling asleep (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). According to the study done on the effect of chemotherapy and radiotherapy on red blood cells and hemoglobin in cancer patients, there was the difference of the level red blood cells in pre-chemotherapy and post chemotherapy (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Administration of drugs for chemotherapy cause damage to non-cancer cells and this leads to low count of white blood cells following chemotherapy (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eChemotherapies affect the numbers of blood cells and biochemical profiles in different ways. Chemotherapies function as alkalizing chemicals and cause the bone marrow's hematopoietic stem cells to disappear gradually (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Chemotherapy usually works by blocking the creation of deoxyribonucleic acid (DNA), proteins, and microtubules, which results in the death of cells or the prevention of their proliferation (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Chemotherapeutic drugs cause DNA damage during replication by covalently binding to the DNA of bone marrow cells to generate intra- and inter-strand cross-links. Platelets, leukocytes, and hemoglobin levels all drop (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). A study done on the effect of chemotherapy on hemoglobin revealed that there was no any significant association hemoglobin and chemotherapy (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eChemotherapy-treated cancer patients have been shown to experience immune system changes and anemia. Frequent, intense chemotherapy has been shown to decrease immune cells that lead to opportunistic infections (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Chemotherapy side effects are noticeable in the bone marrow, a key source of pluripotent hematopoietic stem cells (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMoreover, the use of drugs that are specifically made to be cytotoxic in the complicated field of cancer treatment invariably has detrimental effects on blood cells profile. Many of these medications are mostly metabolized in the liver, therefore while administering chemotherapy, liver-drug interactions need to be taken into consideration (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Chemotherapy administration presents a challenge to the careful control and equilibrium of liver function. Because of the liver's easy absorption of the majority of chemotherapy medicines, up to 85% of patients experience liver stenosis (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Chemotherapy administered repeatedly can cause permanent damage to the liver by drawing in inflammatory cells and changing the levels of enzymes such as lactate dehydrogenase (LDH), ALT, AST, and alkaline phosphatase (ALP) and it can leads to decrease of erythropoietin(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe volume of platelet count after chemotherapy of patient with cancer showed decrement due to the effect of chemotherapy. However, studies done on ovarian cancer showed that there was increment of thrombocytes.(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThere are controversial findings on the difference of the count on blood cell types on different studies. Most studies focused on the relationship between specific cancer type and single blood cell type. Studies are limited on the count of blood cell type before and after chemotherapy of patients with different cancer conditions in the specified areas. Knowing on the changes of blood cell type profiles is substantial for taking appropriate interventions. Therefore, this study aimed to address this gap and provide different scientific bases for various stakeholders.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study was done in Mekele comprehensive specialized hospital, northern part of Ethiopia. The hospital has two-oncology center. These oncology centers were pediatric oncology center and adult oncology center.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo compare blood cells type count difference in pre-operative and post-operative patients with cancer, an institutional based follow up study design was used from september1, 2022 to October 1, 2022.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePopulations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll patients with all type of cancer attended the hospital for chemotherapy were source populations and patients who started chemotherapy treatment from September 2018 to September 2022 were study populations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and exclusion criteria\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll type of cancer patient who had complete medical record such as demographic record, stage of cancer, all type of blood cells counts were included in the study. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Exclusion criteria\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThose patients with comorbid conditions\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePatients who lose follow up before completing cycle IV treatment were excluded from the study\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eSampling method and sample size determination\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;All samples that fulfill the inclusion criteria were taken. The total samples were 354 samples. The required data were selected from these 354 samples, which were admitted in the oncology unit from September 2018 to september2022.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperation terms\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePre-chemotherapy level of blood cell type\u003c/strong\u003e: this is the level of blood cells at the time of diagnosis and before starting chemotherapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePost-chemotherapy level of blood cell type\u003c/strong\u003e: this is the level of blood cells after finishing the phase four treatment of chemotherapy \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVariables of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIndependent variable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChemotherapy is independent variable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDependent variable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eType of blood cells such as red blood cell, white blood cells and platelets\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection tools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData extraction format was used to collection the required information from secondary data source. So as to collect the required information the first the register log book was reviewed and we took the patients\u0026rsquo; medical registration number, and the redundancy of MRN were removed by using excel. Finally, data were collection from smart care and patient individual folder. \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod of data processing and analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst data were entered and cleaned to epidata version 4.6. After that data was exported to SPSS version 23 for analysis. The level of the type of blood cell changes after and before chemotherapy was compared by using paired t-test. All assumptions of the test was done.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData quality control\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst data preparation checklist was adapted from different articles. The prepared checklist format was tested on 50 samples first before going to the actual data collection. The aim of the study was briefly explained to data collectors. The data collectors were one nurse from oncology unit, one smart care administrator and the other is one from card room workers. One day raining was given to these data collectors. The daily inspection how to fill the checklist was supervised.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic characteristics of the patient\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Data were collected from 354 patients with all type of cancer before and after phase IV chemotherapy were taken from September 2018 to September 2022. \u0026nbsp;The number of female and male were 215 (60.7%) and 139 (39.3%) respectively (table1). The mean age of the respondent was 41.26 (\u0026plusmn;16.67).\u003c/p\u003e\n\u003cp\u003eTable1. Age and sex of the patient with cancer at oncology center of Mekele comprehensive and\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 289px;\"\u003e\n \u003cp\u003eAge category in years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eSex of the respondents\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eFrequency\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the age group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e69.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e31.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the sex group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e14.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e4.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e19-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the age group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e40.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e59.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the sex group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e20.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e19.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e20.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e31-45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the age group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e23.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e79.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the sex group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e19.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e41.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e33.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e46-65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the age group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e46.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e54.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the sex group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e45.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e34.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e38.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e354\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the age group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e39.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e60.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e% with the sex group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eType of cancer among the participant of the study\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the total patients the leading type of cancer are breast cancer 133 (37.6%), lymphoma 89 (25.1%) and sarcoma 36 (10.2%) respectively (table 2). At the time of first contact nearly all of them reached stage III and stage IV with 167 (47%) and 159 (45%) respectively. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2.Type of cancer among patient with cancer at oncology center of Mekele comprehensive and specialized hospital in2022\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eFrequency\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003ePercent\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eCumulative\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eType of cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eBreast cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e37.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003elymphoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e62.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eSarcoma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e72.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eColon cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e79.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eStomach cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e80.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eLung cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e82.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eRectal cancer \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eleukemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eBone cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e89.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eDifference of the count of blood cell type in pre-chemotherapy and post-chemotherapy among patients with cancer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe profile of blood cell type before and after chemotherapy is shown in the table 3. Three type of blood cells namely red blood cells, white blood cells and platelets were measured at the time of diagnosis and after phase IV of chemotherapy. \u0026nbsp;The mean value of red blood cells and white blood cell were measured using cells per mm\u003csup\u003e3\u003c/sup\u003e\u0026times;10\u003csup\u003e6\u003c/sup\u003e. The mean values of platelets were also measured by using cell mm\u003csup\u003e3\u003c/sup\u003e\u0026times;10\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e(table 3).\u003c/p\u003e\n\u003cp\u003eTable3. Comparison of the level of blood cell type between pre-chemotherapy and post chemotherapy in Mekele comprehensive and specialized hospital in 2020 \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"696\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003epairs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMeasure of blood cells pre and post\u003c/p\u003e\n \u003cp\u003eChemotherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003emean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eMean Paired difference\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e95% \u0026nbsp;CI of mean differences\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eLower\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eUpper\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePair1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eRed blood cell pre-chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRed blood cell post-chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e4.90\u003c/p\u003e\n \u003cp\u003e4.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePair2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003ewhite blood cell pre-chemotherapy\u003c/p\u003e\n \u003cp\u003ewhite blood cell post-chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e10.99\u003c/p\u003e\n \u003cp\u003e8.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e2.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePair3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003ePlatelet pre-chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePlatelet post-chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e316.82\u003c/p\u003e\n \u003cp\u003e293.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e23.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e9.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e37.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAs shown from the above table3,\u0026nbsp;all profiles of blood cell type showed decrement in post chemotherapy compared to pre-chemotherapy. The mean decrement of platelet is 23.51 \u0026times;10\u003csup\u003e3\u003c/sup\u003e cells/mm\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e(p=0.001), red blood cell is 0.63\u0026times;10\u003csup\u003e6\u0026nbsp;\u003c/sup\u003ecells/mm\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e(p=0.08) and white blood cell is 2.49 \u0026times;10\u003csup\u003e6\u0026nbsp;\u003c/sup\u003ecells/mm\u003csup\u003e3\u0026nbsp;\u003c/sup\u003e(p=0.012) respectively.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTreatment for cancer has dis advantage on normal blood cell types. The drugs given for this treatment are cytotoxic on active cells (4, 15, 16). Cancer cells are normal, healthy and can multiply and the disadvantage of chemotherapy drugs occur when these drugs disrupt the normal function and multiplication of the cells healthy cells (17). Cancer patients who had been undergone in chemotherapy faced substantially life-threating complications like low in hemoglobin level and reduction of white blood cells. This led to anemia and exposure of different infections (11).\u003c/p\u003e\n\u003cp\u003eIn this follow up study, the paired mean value of blood cell types among patients in pre-chemotherapy and post chemotherapy were measured. The result of this study revealed that the counts mean value of red blood cells was reduced in post-chemotherapy compared to pre-chemotherapy. This study is in lined with the study done on the effect of chemotherapy and radiotherapy on red blood cells and hemoglobin in cancer patient (4). This suppression of red blood cells might be because chemotherapy suppressed the bone marrow, which produces normal and active red blood cells (2). The other explanation for this reduction is, many drugs that are used for treating cancerous cells damage the normal red blood cells. Therefore, the reduction of red blood cells leads to reduction of hemoglobin and hematocrit. The erythropoiesis production may be compromised because of chemotherapy and this disruption led to reduction of red blood cells. Drugs of chemotherapy also induce renal toxicity. Nephrotoxic drugs that are taken for chemotherapy significantly disrupt erythropoietin production. The other reason for this decrement may be erythropoietin reduction. \u003c/p\u003e\n\u003cp\u003eThe number of platelet count in this study reported as presence of huge difference between pre-chemotherapy and post-chemotherapy in patients with cancer. The difference may be happed to the reason that hormones produced in the kidney and liver to produce platelets disrupted by chemotherapy (18, 19). The number of platelet count in post chemotherapy compared to pre-chemotherapy is high. This study is opposite to the study of meta-analysis done on ovarian (14). This difference may happen because this study included all type of cancer and the mentioned article was done on only ovarian cancer.\u003c/p\u003e\n\u003cp\u003eAccording to the result of this study, the number of white blood cell count decreased after chemotherapy compared to pre-chemotherapy (20, 21). This similarity may be happened to the fact that the given drugs for chemotherapy were similar. The other for this consistency result is that chemotherapy has cytotoxic effect to disrupt the normal production of white blood cells. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrength and limitation of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrength \u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eAll type of cancer patient were include in the study\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eLimitation \u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eSince data was from secondary source some data were not registered\u003c/li\u003e\n\u003cli\u003eOther biochemical profiles were not considered \u003c/li\u003e\n\u003cli\u003eChanges from phase to phase are not compared \u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Conclusion and recommendations ","content":"\u003cp\u003eAll blood cells namely red blood cells, white blood cells and platelets had decreased in their number among patients with Chemotherapy. As the result of this study showed the decrement of all cells is significant. As a result it would be best recommended to replace the decrements of blood cells during chemotherapy.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance for this study obtained from Debre Markos University College of medicine and health science.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participant\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSince data for this study was taken from secondary source, direct consent was not taken\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTadele Derbew Kassie and Ayisheshm Asnake Abneh write the proposal, analysis \u0026nbsp;data and write the original draft\u0026nbsp;and edit the final document, Bayu Wondimneh Yimenu,Gelagay Baye Temesgen\u003csup\u003e\u0026nbsp;\u003c/sup\u003eand Rahel Asres Shimelash, Ayisheshim Asnake Abneh excut data,conceptualization and write the document,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, we would like to express our gratitude to the almighty God. Second, we would also thank to Debre Markos College of medicine and health science research and community service office to support us in technical assistances.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAt any time, the corresponding author is responsible to give any additional resource when requested.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared that there is no potential conflict of interest with respect to the research, authorship and publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declared that there is no funding for this research article.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLodish HF. Molecular cell biology: Macmillan; 2008.\u003c/li\u003e\n\u003cli\u003eGebremeskel G, Baye G. Bayu Wondimneh Sathisha Anekere Dasappa Setty 2 Gebrekidan Gebregzabher Asfeha 2 Ezra Belay 2. Cancer Management and Research. 2021;13:625-32.\u003c/li\u003e\n\u003cli\u003eAziz HA, Habeeb JM. Study the Effect of Chemotherapy on Some Hematological and Biochemical Parameters of Cancer Patients in AL-Muthanna Province, Iraq. Indian Journal of Public Health Research \u0026amp; Development. 2019;10(2).\u003c/li\u003e\n\u003cli\u003eYounis M, Iqbal M, Shoukat N, Nawaz B, Watto F, Shahzad KA. Effect of chemotherapy and radiotherapy on red blood cells and haemoglobin in cancer patients. Sci Lett. 2014;2(1):15-8.\u003c/li\u003e\n\u003cli\u003eLowenthal RM, Eaton K. Toxicity of chemotherapy. Hematology/Oncology Clinics. 1996;10(4):967-90.\u003c/li\u003e\n\u003cli\u003eXuequan C, Langxiao T. The New Reform of China\u0026apos;s Lay Assessor System. China Legal Sci. 2020;8:3.\u003c/li\u003e\n\u003cli\u003ePadma R, Sundaresan S. Haematological and biochemical changes in pre and post-treatment of buccal mucosa carcinoma patients. Int J PharmSci Res. 2016;7(7):3002-6.\u003c/li\u003e\n\u003cli\u003eKaplan BW PDPmfEatw, background Aphatiuo, Ther. pwbWKbpC, 2013;(April):5\u0026ndash;62.\u003c/li\u003e\n\u003cli\u003eWei Y-S, Zhou Y-G, Wang G-Y, Liang Z-H, Luo M-R, Yang T-A, et al. The impact of chemotherapy-associated hemoglobin on prognosis of colorectal cancer patients receiving adjuvant chemotherapy. Cancer Biomarkers. 2017;20(4):627-35.\u003c/li\u003e\n\u003cli\u003eMedrano-Casique N, Tong HY, Borobia AM, Carcas AJ, Fr\u0026iacute;as J, Ram\u0026iacute;rez E. Nonchemotherapy drug-induced agranulocytosis in children detected by a prospective pharmacovigilance program. Pediatric Hematology and Oncology. 2016;33(7-8):441-56.\u003c/li\u003e\n\u003cli\u003eSiena S, Secondino S, Giannetta L, Carminati O, Pedrazzoli P. Optimising management of neutropenia and anaemia in cancer chemotherapy\u0026mdash;advances in cytokine therapy. Critical reviews in oncology/hematology. 2003;48:S39-S47.\u003c/li\u003e\n\u003cli\u003eSobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours: John Wiley \u0026amp; Sons; 2011.\u003c/li\u003e\n\u003cli\u003eNetwork N. Cancer-and Induced Anemia. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u0026reg;). 2018:1-51.\u003c/li\u003e\n\u003cli\u003eEggemann H, Ehricke J, Ignatov T, Fettke F, Semczuk A, Costa S, et al. Platelet count after chemotherapy is a predictor for outcome for ovarian cancer patients. Cancer Investigation. 2015;33(5):193-6.\u003c/li\u003e\n\u003cli\u003eNowrousian M, Waschke S, Bojko P, Welt A, Schuett P, Ebeling P, et al. Impact of chemotherapy regimen and hematopoietic growth factor on mobilization and collection of peripheral blood stem cells in cancer patients. Annals of oncology. 2003;14:i29-i36.\u003c/li\u003e\n\u003cli\u003eAldarouish M, Su X, Qiao J, Gao C, Chen Y, Dai A, et al. Immunomodulatory effects of chemotherapy on blood lymphocytes and survival of patients with advanced non-small cell lung cancer. International journal of immunopathology and pharmacology. 2019;33:2058738419839592.\u003c/li\u003e\n\u003cli\u003eNoviyani R, Indrayathi PA, Budiana IG, Niruri R, Tunas K, Adnyani NDD. Effect of paclitaxel-cisplatin chemotherapy towards hemoglobin, platelet, and leukocyte levels in epithelial ovarian cancer patients. Journal of Applied Pharmaceutical Science. 2019;9(1):104-7.\u003c/li\u003e\n\u003cli\u003eFerroni P, Guadagni F, Riondino S, Portarena I, Mariotti S, La Farina F, et al. Evaluation of mean platelet volume as a predictive marker for cancer-associated venous thromboembolism during chemotherapy. Haematologica. 2014;99(10):1638.\u003c/li\u003e\n\u003cli\u003eBessman D. Prediction of platelet production during chemotherapy of acute leukemia. American Journal of Hematology. 1982;13(3):219-27.\u003c/li\u003e\n\u003cli\u003eHan HS, Rybicki LA, Thiel K, Kalaycio ME, Sobecks R, Advani A, et al. White blood cell count nadir following remission induction chemotherapy is predictive of outcome in older adults with acute myeloid leukemia. Leukemia \u0026amp; lymphoma. 2007;48(8):1561-8.\u003c/li\u003e\n\u003cli\u003eRibeiro R, Broniscer A, Rivera G, Hancock M, Raimondi S, Sandlund J, et al. Philadelphia chromosome-positive acute lymphoblastic leukemia in children: durable responses to chemotherapy associated with low initial white blood cell counts. Leukemia. 1997;11(9):1493-6.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"blood cell type, chemotherapy, differences, patient with cancer, northern Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-4963614/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4963614/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Cancer is a disorder involving uncontrolled growing cells that have the ability to invade and spread to other areas of the body. \u0026nbsp;Drugs for chemotherapy cause damage to non-cancer cells and leads to low count of blood cells. There are controversial findings on the difference of the count on blood cell types. Studies are limited on the count of blood cell type before and after chemotherapy. Therefore, this study aimed to address this gap.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: Institutional based longitudinal study design was done on 354 patients to compare blood cell types profile in pre and post-operative from September1, 2022 to October 1, 2022. Data extraction format was used to collection data source. To assure data quality, first data were entered and cleaned to epidata version 4.6 then exported to SPSS version 23 for analysis. Paired t-test was used to analysis data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult: \u003c/strong\u003edata was collected from 354 patients. The mean age of the respondent was 41.26 (±16.67). In the first diagnosis, nearly all of them reached stage III 167 (47%) and stage IV 159 (45%). All profiles of blood cell type showed decrement in post chemotherapy compared to pre-chemotherapy. The mean decrement of platelet is 23. 51×10\u003csup\u003e3\u003c/sup\u003ecells/mm\u003csup\u003e3 \u003c/sup\u003e(p=0.001), red blood cell is 0.63×10\u003csup\u003e6\u003c/sup\u003ecells/mm\u003csup\u003e3 \u003c/sup\u003e(p=0.08) and white blood cell is 2.49 ×10\u003csup\u003e6 \u003c/sup\u003ecells/mm\u003csup\u003e3 \u003c/sup\u003e(p=0.012) respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e After chemotherapy, all profiles of blood cells count decreased. This means\u003cstrong\u003e\u0026nbsp; \u0026nbsp;\u003c/strong\u003echemotherapy had significant effect on the number of all type of blood cells.\u003c/p\u003e","manuscriptTitle":"Differences on the count of blood cells in pre-chemotherapy and post chemotherapy of patient with cancer in northern Ethiopia 2022, a longitudinal study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-26 18:06:12","doi":"10.21203/rs.3.rs-4963614/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2c1218f8-6cec-4272-860c-7e5501572cf7","owner":[],"postedDate":"September 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-28T09:09:20+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-26 18:06:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4963614","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4963614","identity":"rs-4963614","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}