article · Zenodo (CERN European Organization for Nuclear Research)
Breast cancer remains the most common cancer among women globally and in Cameroon. While chemotherapy is a cornerstone treatment, it has been linked to endothelial inflammation and changes in blood levels of von Willebrand factor, a protein involved in blood clotting. A cross-sectional analytical study conducted across two hospitals in Douala evaluated blood levels of this factor in 55 breast cancer patients undergoing chemotherapy compared to 33 healthy control blood donors. Measurements taken via sandwich ELISA revealed that cancer status and specific chemotherapy regimens, particularly an anthracycline-based doxorubicin-cyclophosphamide protocol, were significantly associated with altered concentrations of the protein. The study demonstrated a significant decrease in von Willebrand factor levels following chemotherapy in this group, alongside links to tumour grade, metastasis, anaemia, platelet count, and traditional medicine use. This pattern contrasts with findings reported in other global settings.
Chemotherapy can affect blood vessels and clotting mechanisms, potentially impacting patient safety during cancer care. Demonstrating that von Willebrand factor levels drop during chemotherapy in this Cameroonian cohort, contrary to patterns seen elsewhere, highlights the importance of generating local clinical evidence. It suggests that tracking this biological marker could help clinicians better monitor treatment responses and side effects in African breast cancer patients.
This research is early-stage clinical observational work that points to the potential use of von Willebrand factor testing as a monitoring tool in oncology care. Diagnostic laboratories and clinicians managing chemotherapy regimens are the primary potential end users. However, further validation is required before standardising testing protocols or developing dedicated diagnostic kits for clinical use in this patient population.
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Background: Cancer is a major global health problem, particularly in low-income countries. In 2022, an estimated 2.5 million new cancer cases were recorded worldwide, 11.6% of which were breast cancers, the most frequent cancer in women. In Cameroon, breast cancer incidence was estimated at 4207 cases the same year. Invasive ductal carcinoma remains the most common histological subtype. Among the treatments used, chemotherapy is widely applied, but recent studies suggest it may trigger endothelial inflammation with abundant release of von Willebrand factor (VWF) into the bloodstream. This study aimed to determine the effect of chemotherapy on VWF concentration in patients with breast cancer followed in two hospitals in Douala. Methods: We conducted a cross-sectional analytical study over six months, comparing breast cancer patients receiving chemotherapy with healthy blood donors serving as controls. Sociodemographic and clinical data were collected using a structured questionnaire and patients' medical records, while VWF concentration was measured by sandwich ELISA. Means and standard deviations were calculated for quantitative variables, and a p-value below 0.05 was considered statistically significant. Results: Eighty-eight participants were recruited, comprising fifty-five breast cancer patients and thirty-three blood donors, with a mean age of 47±9 years. Patient status (cancer vs. control) was significantly associated with VWF concentration (p=0.003), as was the chemotherapy protocol used (p=0.001), particularly the anthracycline-based doxorubicin-cyclophosphamide protocol (p=0.003). Several other clinical and biological variables were also significantly associated with VWF variation, including tumour grade, TNM classification, presence of metastasis, anaemia, platelet count and use of traditional medicine. Conclusions: Chemotherapy, particularly anthracycline-based regimens, is associated with a significant decrease in VWF concentration among breast cancer patients in this Cameroonian population, contrary to reports from several other settings. These findings support the integration of VWF measurement into the biological monitoring of patients undergoing chemotherapy, especially in African populations where such data remain scarce.
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DOI: 10.5281/zenodo.22639618
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