Incidence and risk factors for febrile neutropenia of patients with diffuse large B-cell lymphoma receiving R-CHOP-21 in China.

Autor: Zheng W; Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Chen Z; Department of Critical Care Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Zhu S; Department of Laboratory Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Cheng L; Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Hu Y; Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Yang Y; Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Tan M; Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China., Ning H; Senior Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China. ninghongmei72@sina.com., Guan L; Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572000, Hainan, China. 15701572628@163.com.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2023 Dec 19; Vol. 32 (1), pp. 43. Date of Electronic Publication: 2023 Dec 19.
DOI: 10.1007/s00520-023-08250-z
Abstrakt: Objective: Febrile neutropenia (FN) is a serious complication of patients with diffuse large B-cell lymphoma (DLBCL) receiving R-CHOP-21. The prophylactic use of granulocyte colony-stimulating factors (G-CSFs) can significantly reduce the risk of FN. International guidelines recommend G-CSFs for patients receiving chemotherapy with FN risk of 20% or 10 to 20% with defined risk factors. However, there are few studies on the incidence and risk factors of FN in patients with DLBCL receiving R-CHOP-21, especially in patients without primary G-CSF prophylaxis.
Methods: We conducted a retrospective analysis for the clinical data of 103 patients with DLBCL who underwent first R-CHOP-21 without primary G-CSF prophylaxis. The objective of the assessment was the incidence and risk factors of FN after the first chemotherapy cycle.
Results: After the first chemotherapy cycle, the incidence of FN was 20.4%. Multivariate analysis showed that age ≥ 65 years, bone marrow involvement, albumin < 35 g/L, and average relative dose intensity ≥ 80% were independent risk factors for FN. According to risk factors, we created a risk score system. The incidence of FN in the low-, intermediate- and high-risk groups was 5.6%, 17.2%, and 61.9%, respectively.
Conclusion: Our data indicated that R-CHOP-21 itself is associated with a high-risk regiment for FN. We recommend that intermediate/high-risk patients should actively consider primary G-CSF prophylaxis to reduce the incidence of FN after chemotherapy.
(© 2023. The Author(s).)
Databáze: MEDLINE
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