Keeping count for chemotherapy patients

Wednesday 7th June 2017

A new trial at Leeds CRF is profiling the white blood cell count of chemotherapy patients to find a means of identifying those most at risk of severe infections.

One of the most serious complications for chemotherapy patients is the risk of infections due to the impact of the treatment on their immune system. Using daily blood tests, the trial at the Leeds CRF will monitor up to 250 patients for the levels of a type of white blood cell, known as a neutrophil, which help the body fight infection.

The aim is to see how levels of these cells fall and rise again under different chemotherapy treatments and whether there is any pattern that indicates which patients are more likely to get very low levels of neutrophils and could  go on to develop potentially serious infections..

Senior research nurse on the trial, Suzanne Rogerson explains: “We know that chemotherapy causes the neutrophil count to drop in all patients, but we don’t know how many patients develop a condition called severe neutropenia, when the count goes extremely low, or how long the neutrophil count takes to normalise in different patients. Understanding how these changes occur across a large group could help us improve treatment and reduce risks for patients undergoing chemotherapy.”

Previous research in this area has been limited, due to the difficulty of asking patients to attend hospital daily, over an extended period, so that blood samples can be taken. To overcome this problem, the trial will use a new device based on a technology developed by Swedish company HemoCue, which automatically tests for neutrophil levels using only a finger prick sample of blood. Initially the sample will be taken by a nurse at the patient’s home. The technology is being developed to enable patients to take their own samples at home in future trials, with the results transmitted immediately to the hospital.

The long-term aim is that patients are monitored remotely for signs of infection, ensuring antibiotics are given only when needed and reducing visits to hospital. It may also be possible to tailor chemotherapy dosage and regime by taking into account the impact on the neutrophil count of each patient, starting the next round of treatment as soon as neutrophil levels have returned to normal.

“At the moment, subsequent rounds of chemotherapy are given at set doses over set time periods for all patients, but it’s possible that, based on their neutrophil count, some patients could have a larger dose or move onto their next round of treatment sooner, which might improve the outcome,” said Suzanne Rogerson. “The basic understanding we hope to gain through this trial could be applied in a number of ways to help us improve how patients receive treatment for cancer.”

The trial – which has already recruited its first patients –  is led by Dr Geoff Hall. It is funded through an Innovate UK Small Business Research Initiative to Phillips Healthcare BV, and sponsored by the University of Leeds.