VARIATIONS OF VON WILLEBRAND FACTOR IN WOMEN WITH BREAST CANCER UNDERGOING CHEMOTHERAPY IN DOUALA

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.