THE EFFECTS OF CAPOX AND FOLFOX ON THE IMMUNE CELL PROFILES OF COLON CANCER PATIENTS ATTENDING USMANU DANFODIYO UNIVERSITY TEACHING HOSPITAL, SOKOTO.

Abstract

Colon cancer remains a major public health challenge globally and in Nigeria, with chemotherapy forming a cornerstone of its management. However, chemotherapeutic agents may adversely affect immune cell integrity, thereby increasing susceptibility to infections and treatment-related complications. This study evaluated and compared the effects of CAPOX (capecitabine plus oxaliplatin) and FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) on immune cell profiles of colon cancer patients attending Usmanu Danfodiyo University Teaching Hospital, Sokoto. A comparative cross-sectional study design was adopted involving 52 histologically confirmed colon cancer patients receiving either CAPOX or FOLFOX chemotherapy. Five milliliters of venous blood were collected in EDTA containers before and after chemotherapy cycles. Immune cell profiles were assessed using an automated SYSMEX KX-21N hematology analyzer. Data were analyzed using SPSS version 20.0. Descriptive statistics were used to summarize demographic characteristics, while paired and independent sample t-tests were employed to assess intra- and inter-regimen differences, with statistical significance set at p < 0.05. The study population was predominantly middle-aged to elderly, with a slight male predominance. Both CAPOX and FOLFOX regimens produced mild alterations in immune cell parameters following chemotherapy. CAPOX was associated with relatively preserved lymphocyte counts, while FOLFOX showed a tendency toward lymphocyte reduction with corresponding increases in neutrophils and monocytes. However, these changes were not statistically significant. Comparative analysis revealed no significant difference between CAPOX and FOLFOX in their effects on immune cell profiles. CAPOX and FOLFOX chemotherapy regimens exert comparable and generally mild effects on immune cell profiles among colon cancer patients at UDUTHS. Routine immune monitoring is recommended to support early detection of hematological alterations and optimize patient management during chemotherapy.