Patterns of Neutropenia and Risk Factors for Febrile Neutropenia of Diffuse Large B-Cell Lymphoma Patients Treated with Rituximab-CHOP.
10.3346/jkms.2014.29.11.1493
- Author:
Yong Won CHOI
1
;
Seong Hyun JEONG
;
Mi Sun AHN
;
Hyun Woo LEE
;
Seok Yun KANG
;
Jin Hyuk CHOI
;
U Ram JIN
;
Joon Seong PARK
Author Information
1. Department of Oncology-Hematology, Ajou University School of Medicine, Suwon, Korea. jspark65@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Febrile Neutropenia;
Lymphoma;
Large B-Cell;
Diffuse;
R-CHOP Chemotherapy
- MeSH:
Adolescent;
Adult;
Age Factors;
Aged;
Antibodies, Monoclonal, Murine-Derived/adverse effects/*therapeutic use;
Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use;
Chemotherapy-Induced Febrile Neutropenia/*etiology;
Cyclophosphamide/administration & dosage/adverse effects/therapeutic use;
Demography;
Doxorubicin/administration & dosage/adverse effects/therapeutic use;
Female;
Humans;
Lymphoma, Large B-Cell, Diffuse/*drug therapy;
Male;
Middle Aged;
Neoplasm Staging;
Neutropenia/etiology/pathology;
Prednisone/administration & dosage/adverse effects/therapeutic use;
Retrospective Studies;
Risk Factors;
Sex Factors;
Vincristine/administration & dosage/adverse effects/therapeutic use;
Young Adult
- From:Journal of Korean Medical Science
2014;29(11):1493-1500
- CountryRepublic of Korea
- Language:English
-
Abstract:
Febrile neutropenia (FN) is the major toxicity of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen in the treatment of diffuse large B-cell lymphoma (DLBCL). The prediction of neutropenia and FN is mandatory to continue the planned R-CHOP therapy resulting in successful anti-cancer treatment. The clinical features and patterns of neutropenia and FN from 181 DLBCL patients treated with R-CHOP were analyzed retrospectively. Sixty percent (60.2%) of patients experienced at least one episode of grade 4 neutropenia. Among them, 42.2% of episodes progressed to FN. Forty-eight percent (48.8%) of patients with FN was experienced their first FN during the first cycle of R-CHOP. All those patients never experienced FN again during the rest cycles of R-CHOP. Female, higher stage, international prognostic index (IPI), age > or =65 yr, comorbidities, bone marrow involvement, and baseline serum albumin < or =3.5 mg/dL were significant risk factors for FN by univariate analysis. Among these variables, comorbidities (P=0.009), bone marrow involvement (P=0.006), and female gender (P=0.024) were independent risk factors for FN based on multivariate analysis. On observing the patterns of neutropenia and FN, primary prophylaxis of granulocyte colony-stimulating factor (G-CSF) and antibiotics should be considered particularly in female patients, patients with comorbidities, or when there is bone marrow involvement of disease.
