ArticleFrontiers in oncology2026
Case Report: Life-threatening neutropenia with absolute neutrophil count of zero after low-dose regional arterial infusion chemotherapy to lung in a patient with advanced triple-negative breast cancer after multiple lines of treatment.
Article in Frontiers in oncology, 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: The risk of severe myelosuppression following regional arterial perfusion chemotherapy in heavily pre-treated patients is often underestimated, especially when pre-treatment hematologic status appears adequate. This case highlights the unexpectedly profound bone marrow toxicity that can occur under these circumstances and details the critical management strategies required. Case presentation: We report a case of a 51-year-old female patient with advanced triple negative breast cancer (TNBC) who developed severe myelosuppression following regional arterial perfusion chemotherapy, despite the chemotherapy dose being lower than the standard systemic dose. The patient had grade I myelosuppression before regional arterial perfusion chemotherapy; however, after perfusion with albumin paclitaxel and gemcitabine, she developed life-threatening severe myelosuppression, with absolute neutrophil count (ANC) dropping to 0 and remaining ≤0.01×10 Conclusion: This case underscores that locoregional chemotherapy, even at reduced doses, can cause profound myelosuppression in extensively pre-treated patients. It also illustrates that a pre-treatment ANC within the normal range may not reliably reflect bone marrow reserve in this population. Prompt, intensive supportive care-including prophylactic antibiotics, G-CSF, and protective isolation-is essential. In carefully selected patients during early hematologic recovery, under strict infection prevention measures and multidisciplinary evaluation, invasive procedures such as thoracentesis may be feasible.
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