The need for improved neutropenia risk assessment in DLBCL patients receiving R-CHOP-21: findings from clinical practice

Leuk Res. 2012 May;36(5):548-53. doi: 10.1016/j.leukres.2012.02.002. Epub 2012 Mar 3.

Abstract

Febrile neutropenia (FN) risk-assessment and granulocyte-colony stimulating factor (G-CSF) prophylaxis use in clinical practice was evaluated in patients with diffuse large B-cell lymphoma receiving R-CHOP-21. More G-CSF primary prophylaxis was used in patients assessed as high FN risk, but R-CHOP-21 was associated with substantial myelotoxicity in both high- and low-risk groups. In a multivariate analysis, older age, poor performance status, lower baseline hemoglobin, and lack of G-CSF prophylaxis were significantly associated with occurrence of FN in any cycle. Results highlight the need for improved FN risk-assessment and thorough guideline adherence to further reduce FN and better support chemotherapy delivery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cyclophosphamide / adverse effects
  • Doxorubicin / adverse effects
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutropenia / chemically induced*
  • Prednisone / adverse effects
  • Risk Assessment*
  • Risk Factors
  • Rituximab
  • Vincristine / adverse effects

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • R-CHOP protocol
  • Granulocyte Colony-Stimulating Factor
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone