Supplementary Material for: Uncommon Complication of Trans-arterial Chemo-embolization with Doxorubicin: A Case of Post-TACE Neutropenia in Hepatocellular Carcinoma

Background: Trans-arterial chemo-embolization (TACE) using doxorubicin is an established treatment option for unresectable hepatocellular carcinoma (HCC) in cirrhotic patients. In this case report, we describe a rare occurrence of delayed febrile neutropenia following conventional TACE (C-TACE) with doxorubicin. This complication, while recognized with systemic doxorubicin, is rarely documented in the context of C-TACE.
Case presentation: We present a 53-year-old Bangladeshi man with hepatitis B-related HCC who developed febrile neutropenia two weeks following C-TACE with doxorubicin. Indeed, previous C-TACE procedures had also resulted in similar neutropenic episodes, which pointed to the association of C-TACE with doxorubicin and neutropenia.
Conclusions: The case brings attention and vigilance to the monitoring for neutropenia in patients receiving C-TACE with doxorubicin, an association rarely currently documented in the literature. Further studies are needed to assess its prevalence and identify risk factors and management strategies for this complication.