We present a case of nasopharyngeal carcinoma complicated with hyperleucocytosis. After ruling our other causes we concluded that the hyperleucocytosis was due to paraneoplastic leukemoid reaction (PLR). The overall survival was 15 months which is rare among patients with PLR
Nasopharyngeal Neoplasms

There are many options in the treatment of heavily pretreated metastatic breast cancer however none of the therapeutic agents have shown promising improvement of survival with good toxicity profile. Eribulin is a novel nontaxane microtubule dynamics inhibitor. Two recent clinical trial showed that Eribulin improves progression-free and overall survival in this subset of patients. We report our experience with using Eribulin in five patients with metastatic breast cancer either in second or third-line setting, in our centre.

Objective: Three-weekly docetaxel causes a high rate of febrile neutropenia, especially in the Asian population. Two-weekly docetaxel has been shown to reduce rate of febrile neutropenia in castrate-resistant prostate cancer patients. We conducted a preliminary study to investigate the safety of two-weekly docetaxel in advanced breast cancer patients. Methods: We recruited 10 patients with advanced breast cancer with ECOG (Eastern Cooperative Oncology Group) performance status score of zero to two, who needed chemotherapy in the first or second-line setting to receive two-weekly docetaxel for 8 cycles. The primary endpoint was safety and secondary endpoints were response rate and progression free survival. Results: The most reported adverse events were haematological (anaemia 100% and neutropenia 90%). The febrile neutropenia rate was 10%. The overall response rate was 20%. The median progression free survival was 5.0 months. Conclusion: Two-weekly docetaxel may be a reasonable alternative treatment regimen for patients with advanced breast cancer in the first or second-line setting. This regimen is yet to be compared with standard 3-weekly schedule in a phase 3 randomised clinical trial.

Docetaxel induced febrile neutropenia (FN) is a common adverse event encountered by breast cancer patients worldwide, especially among Asian patients. We aim to evaluate incidence of FN in breast cancer patients receiving docetaxel in Malaysia. We retrospectively reviewed the records from patients with breast cancer who received docetaxel in a university-hospital. The incidence of FN, length of hospital stay, incidence of ICU admission, incidence and grade of neutropenia were evaluated. Among 237 breast cancer patients, incidence of FN was 14.34% (34 patients). Mean length of hospital stay was 9.28 days (2 to 94 days). Two patients (0.84%) required admission to the ICU with the length of stay being 4 and 60 days respectively. Incidences of neutropenia are 27.8% (grade 1), 0.8% (grade 2), 1.69% (grade 3) and 0.4% (grade 4). The incidence of febrile neutropenia due to docetaxel was higher among this population. This data may help to determine the optimal dose of docetaxel in breast cancer patients.
Drug Therapy