Quantifying anticancer drug toxicity on white blood cell count in cancer patients: A mathematical and computational approach

Objectives: White blood cells (WBCs) are immune cells that fight infections and cancers. However, many cancers and their treatment with chemotherapy negatively affect the WBCs count. For oncologists and physicians, it is important to know how much the WBCs count is affected to optimize drug administration. The data of breast cancer patients were included in this study because the largest number of cancer patients were suffering from breast cancer in the under-study hospital. This study presents a computational and mathematical approach to measure the effect on the WBCs count of breast cancer patients treated with chemotherapy with two anticancer drug combinations: docetaxel with cyclophosphamide (TC) and doxorubicin with cyclophosphamide (AC).Methods: Between July 2016 and October 2021, to breast cancer patients, 4 cycles of chemotherapy (one cycle of 21 days) were administered intravenously using TC (75 mg/m2 + 600 mg/m2). Similarly, varying in cases, intravenous AC (60 mg/m2 + 600 mg/m2) was administered in each of the 4 cycles. The WBCs counts of the subjects affected by both TC and AC combinations were observed for comparison. An equation was derived to calculate the effect of TC and AC on WBCs count (eWBCc). The eWBCc of 171 patients who received TC and 154 patients who received AC were calculated by implantation of the derived equation using Python 3.8.Results: Comparing the results of 171 patients, it is observed that, TC affected WBC count of a patient at lowest level by 12.29%, at maximum level by 69.64%, and on average by 34.13%. Whereas, comparing the results of 154 patients, AC affected WBC count of a patient at lowest level by 19%, at maximum level by 65.03%, and on average, by 44.36%. A paired t-test was used to analyze the statistical differences between the eWBCc of both TC and AC cohorts. This test indicates a statistically significant difference between the eWBCc by TC and AC, as evidenced by the P-value of 0.000, which is less than the chosen significance level (alpha) of 0.05.Conclusion: We conclude that TC remains less toxic than AC in affecting white blood cells count of the studied patients.