Vol. 3, Issue 5, Part H (2017)

Patients and methods: This prospective pilot study was conducted on all patients referred to the Oncology department from February to march 2006 and who were to receive chemotherapy. Li2CO3 was given in the dose of 300 mg Bid for seven days from the first day following chemotherapy. Patients expected to experience severe neutropenia were assigned to the study group (Li2CO3) and all other patients were randomly entered to the study and the control group. A total of twenty five patients were enrolled for this study.

Results: The age range was from 15 to 69 years with the median age being 58 years. 46% of the subjects comprised of lung and breast cancer, 26% lymphomas and sarcomas and the remaining 28% having other malignancies. 18% of the patients received combination chemotherapy expected to cause severe neutropenia (more than two myelotoxic drugs), seventy percent received chemotherapy expected to cause moderate neutropenia (two myelotoxic drugs) and twelve percent received chemotherapy expected to cause mild neutropenia (one myelotoxic drug). All the patients had normal prechemotherapy complete blood picture. 73% percent had neutropenia in the second week of which 41% were from the control group and 32% percent from the study group.30% of the patients in the control group had neutropenia extending to the third week delaying the second cycle of chemotherapy. Only one patient had neutropenia at the end of the third week in the study group. All patients in the control group who had their second cycle delayed due to neutropenia were shifted to the study group with hundred percent doses given in the subsequent cycles. These patients continued to receive the full dose with no further delay in the chemotherapy schedule. Febrile neutropenia was seen in two patients of the control group and one in the study group. One patient developed mild nausea and tremors to lithium with no other toxicities observed.

Conclusions: Li2CO3 is a useful drug which helps to reduce the duration of neutropenia following chemotherapy thus enabling a planned dose and schedule to be administered. A large randomized trial is needed to clearly identify the role of Li2CO3 in reducing chemotherapy induced neutropenia, its appropriate dose and toxicities. The easy affordability and availability of this drug makes it an ideal choice for clinical trials in developing countries.