Chemotherapy-induced neutropenia (CIN) and chemotherapy-induced alopecia (CIA) are significant toxicities affecting cancer patients. CIN is a potentially fatal complication of chemotherapy caused by myelosuppression and increased infection susceptibility, while CIA, although not fatal, severely affects treatment adherence and mental health. This study provides a comprehensive comparative analysis of CIN and CIA, focusing on patient, disease, treatment, and genetic risk factors. Key risk factors for CIN and CIA include age, poor performance status, body mass index (BMI), laboratory abnormalities, and pre-existing comorbidities. Both toxicities were significantly associated with breast cancer patients, although CIN patients were more likely to have hematological cancer, and CIA patients were more likely to have solid tumors. Notably, anthracyclines, alkylators, and taxanes frequently induce both toxicities, although their timelines and clinical implications differed. There was no clear overlap between genetic predispositions and toxicities beyond single-nucleotide polymorphisms (SNPs) in the ABCB1 gene. This is the first study to directly compare CIN and CIA, offering insights into personalized oncology care. Understanding the risk factors implicated in the development of CIN and CIA will enable physicians to manage patient outcomes.
化疗诱导的中性粒细胞减少症（CIN）与化疗诱导的脱发（CIN）是影响癌症患者的重要毒性反应。CIN是化疗引起的骨髓抑制及感染易感性增加所导致的潜在致命并发症；而CIA虽不致命，却严重影响患者治疗依从性与心理健康。本研究对CIN与CIA进行了全面比较分析，重点关注患者个体因素、疾病特征、治疗方案及遗传风险因素。CIN与CIA的关键风险因素包括年龄、体能状态低下、体重指数（BMI）、实验室指标异常及既存合并症。两种毒性反应均与乳腺癌患者显著相关，但CIN患者更常见于血液系统恶性肿瘤，而CIA患者更多见于实体肿瘤。值得注意的是，蒽环类药物、烷化剂和紫杉醇类药物常同时诱发两种毒性，但其发生时间线与临床意义存在差异。除ABCB1基因单核苷酸多态性（SNPs）外，遗传易感性与毒性反应之间未发现明确关联。本研究首次直接比较CIN与CIA，为个体化肿瘤治疗提供新见解。深入理解CIN与CIN发生发展的风险因素，将有助于临床医生优化患者预后管理。
Parallel Toxicities: A Comparative Analysis of Chemotherapy-Induced Neutropenia and Alopecia
肿瘤(癌症)患者之家