ArticleHealth science reports2026
Systemic Inflammation and Subclinical Hepatic Synthetic Dysfunction Following Doxorubicin-Cyclophosphamide Chemotherapy in Ethiopian Women With Breast Cancer: A Prospective Cohort Study.
Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Doxorubicin-cyclophosphamide (AC) chemotherapy induces hepatotoxicity through oxidative stress and inflammatory pathway activation, but prospective African data are lacking and conventional liver tests may miss subclinical injury. We evaluated changes in liver enzymes, hepatic synthetic markers, and high-sensitivity C-reactive protein (hs-CRP) after AC chemotherapy in Ethiopian women with breast cancer. Methods: This prospective cohort study enrolled consecutive women (≥ 18 years) with breast cancer scheduled for four cycles of adjuvant/neoadjuvant AC (doxorubicin 60 mg/m Results: Among 43 enrolled patients, 39 (90.7%) completed paired assessments (mean age 43.5 ± 12.3 years; 43.6% premenopausal; 53.5% stage I-II). AC chemotherapy induced an 81% hs-CRP increase (baseline: 3.2 ± 2.1 mg/L; post-AC: 5.8 ± 3.4 mg/L; Δ = +2.6 mg/L; Conclusion: AC chemotherapy was associated with marked systemic inflammation and biomarker changes consistent with subclinical hepatic synthetic impairment in nearly half of patients, not captured by conventional liver panels. Because albumin is also influenced by nutritional and inflammatory factors, this finding is a signal warranting closer monitoring, particularly in older and postmenopausal women, rather than proof of hepatocellular injury. These inexpensive biomarkers should be incorporated into monitoring protocols in resource-limited settings.
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