Evaluation of Complete Blood Count (CBC) among patients with Breast, Ovarian and Colon Cancer Patients Before and After Chemotherapy Administration at Shendi Oncology Center, Sudan- 2026

Abstract

Background: Chemotherapy administrated to cancer patients as it toxic and aiming to confine cancer spread for normal organs has effects, it observed that changes in hematological parameters during anti-cancer drugs differ before starting treatment. To this study aimed to evaluate changes may occur among 3 different cancers’ patients attended to Shendi Oncology center- River Nile State. Method: The study was approved by Sudan International University-hospital administration as well as patients as they already consent for participating in research concerning cancer at any level. Breast, ovarian and colon cancers patients were involved in this study. Patients whole blood samples were collected in 2 phases, first before starting chemotherapy and second after period of time assessed according to number of drugs’ cycles. Complete blood count parameters measured via hematology analyzer Mindray. Data collected analyzed by statistical package of social science (SPSS) version22. Result: Comparison of data before and after chemotherapy with each other showed significant differences in Hb, PCV, MCV, RDW-CV each of them has p value <0.05 and the rest of parameters compared each has p value >0.05. Age was significantly positively correlated with Hb and PCV and negatively correlated with RDW-CV before chemotherapy. After chemotherapy, age showed significant negative correlations with MCHC and RDW-CV and a significant positive correlation with lymphocyte percentage. Other CBC parameters showed no statistically significant correlations with age.

Introduction

This study investigated the effects of chemotherapy on complete blood count (CBC) and hematological parameters in cancer patients attending Shendi Oncology Center in Sudan. Cancer is a major global health problem, and chemotherapy, while effective against rapidly dividing cancer cells, can also suppress bone marrow function and alter blood-cell production.

Study Objective and Methodology

The study used a descriptive cohort design involving 61 cancer patients with:

• Breast cancer: 20 patients (32.8%)
• Ovarian cancer: 20 patients (32.8%)
• Colon cancer: 21 patients (34.4%)

Participants were aged 17–80 years. Blood samples were collected before and after chemotherapy to compare changes in CBC parameters. Data were analyzed using SPSS.

Main Findings

Chemotherapy produced changes in several hematological parameters:

• Hemoglobin (Hb) decreased slightly from 11.8 to 11.3 g/dL, although the overall difference was not statistically significant.
• PCV/Hematocrit decreased from 36.6% to 35.2%, with a statistically significant difference.
• MCV increased from 83.8 to 85.5 fL and showed a highly significant change.
• MCH increased slightly and was statistically significant.
• RDW-CV increased, indicating greater variation in red blood cell size.
• WBC count decreased slightly, but the difference was not statistically significant overall.
• Neutrophil percentage decreased slightly, while lymphocyte percentage increased slightly.
• Platelet count decreased from approximately 329 to 299 ×10?/L, although the overall difference was not statistically significant.

Differences by Cancer Type

• Breast cancer: Most hematological parameters showed only minor changes after chemotherapy. MCV was the main parameter showing a statistically significant change.
• Ovarian cancer: Significant changes were observed in MCV, MCH, RDW-CV, WBC count, and platelet count, suggesting a greater effect of chemotherapy on selected blood parameters.
• Colon cancer: Decreases were observed in Hb, PCV, RBCs, WBCs, neutrophils, and platelets, while MCV, MCH, MCHC, and lymphocyte percentage increased slightly.

Comparison with Controls

Compared with the control group, significant differences were particularly observed in:

• MCH
• MCHC
• RDW-CV
• MCV before chemotherapy
• Platelet count before chemotherapy

However, Hb, PCV, WBCs, neutrophils, lymphocytes, and several other parameters did not show significant differences from controls.

Effect of Age and Disease Duration

Age was significantly associated with some hematological parameters. Before chemotherapy, older age was positively correlated with Hb and PCV and negatively correlated with RDW-CV. After chemotherapy, age showed significant relationships with MCHC, RDW-CV, and lymphocyte percentage.

Disease duration and the number of chemotherapy cycles also showed associations with some blood parameters, but most relationships were weak or not statistically significant.

Overall Conclusion

The study demonstrates that chemotherapy can alter several hematological parameters in cancer patients, particularly red blood cell indices such as MCV, MCH, and RDW-CV, as well as PCV and, in some cancer groups, WBCs and platelets. The effects varied according to cancer type, age, disease duration, and treatment stage. Ovarian and colon cancer patients appeared to show more noticeable changes in several blood parameters than breast cancer patients.

Conclusion

This study evaluated complete blood count (CBC) parameters in 61 cancer patients (20 breast, 20 ovarian, and 21 colon cancer) before and after chemotherapy. The participants had a mean age of 49.7 ± 11.4 years, with disease duration ranging from 0 to 14 years. Colon cancer accounted for 34.4% of cases, while breast and ovarian cancers each represented 32.8%. The chemotherapy resulted in decreased hemoglobin (Hb), packed cell volume (PCV), white blood cell (WBC) count, neutrophil count, and platelet count, whereas mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW-CV) increased. Statistically significant changes after chemotherapy were observed in PCV (p=0.023), MCV (p<0.001), MCH (p=0.010), and RDW-CV (p=0.020), while changes in Hb, WBC, neutrophils, lymphocytes, and platelets were not significant. Comparison with healthy controls showed significant differences in MCV, MCH, MCHC, RDWCV, and platelet count, indicating that cancer and chemotherapy mainly affected red blood cell indices. Among breast cancer patients, chemotherapy produced minimal hematological changes, with MCV being the only parameter that changed significantly. Comparisons with controls demonstrated significant differences in Hb, MCH, MCHC, RDW-CV, and platelet count, while correlations with age, disease duration, and chemotherapy cycles were generally weak, except for significant associations involving MCV, MCH, RDW-CV, MCHC, and post-treatment neutrophil percentage. In ovarian cancer patients, chemotherapy significantly increased MCV, MCH, and RDW-CV, while significantly decreasing WBC and platelet counts. Significant differences compared with controls were mainly observed for MCH, MCHC, RDW-CV, and platelets. Age and disease duration showed selective correlations with hematological indices, particularly involving Hb, neutrophils, mixed cells, WBC, PCV, and Hb after treatment. Among colon cancer patients, chemotherapy significantly reduced PCV and RBC count, whereas other CBC parameters showed no significant changes. Compared with controls, significant differences were observed in MCH, MCHC, and RDW-CV, but age had little influence on CBC parameters. Disease duration showed only one significant association, a negative correlation with neutrophil percentage after chemotherapy. All findings indicate that chemotherapy produces selective hematological alterations, primarily affecting red blood cell indices (PCV, MCV, MCH, RDW-CV) and, to a lesser extent, WBC and platelet counts. The magnitude of these changes varied according to cancer type, with ovarian cancer patients showing the most pronounced hematological effects, while breast and colon cancer patients experienced relatively limited changes.

Copyright

Copyright © 2026 Wala Eldin Osman Elradi, Aisha A. S. Abdallatif , Alaa B. M. Abdrhman, Alaa G B Ibrahim , Ibtisam K. A. Anwar, Omer F A. Mohammed, Maab Shames AL-deen G. A, May A. M. Ashmaig. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.