**6. Adverse effects**

Neutropenia has many negative effects. One of these side effects is dose reduction of chemo‐ therapy. Fifty percent (50%) of cancer patients received less than 85% of the prescribed doses because of neutropenia.

Neutropenia can also cause delays in chemotherapy treatment, which can lead to increase in cancer cell growth and tumor size. Both dose reduction and delay of chemotherapy can have serious effects on patients' lives, and may even lead to death [19, 20].

Neutropenia also has a dramatic and detrimental effect on the patients' quality of life. Fatigue is the predominant characteristic, which leads to a decrease in the ability to perform daily life activities. Patients describe fatigue as feeling weak and exhausted. Psychological problems were also reported by the patients, such as sadness, anxiety, reduced self-worth, and inability to fulfill normal roles [19, 20].
