title: Bone marrow involvement, in intensively treated patients with intermediate grade non-Hodgkin's lymphoma, is a risk factor for granulocytopenia and fever.
abstract: Intensive combination chemotherapy administered to patients with non-Hodgkin's lymphoma (NHL) is inevitably associated with neutropenia and fever. However, the subset of patients who are at increased risk for myelotoxicity has not been clearly identified as yet. We evaluated 58 patients with NHL in order to verify whether bone marrow involvement (BMI) at diagnosis is a risk factor for neutropenia and infection following intensive chemotherapy. Patients with bone marrow involvement had significantly lower neutrophil counts both at diagnosis and following chemotherapy. An higher percentage of patients with BMI developed neutropenia (< 1000/mm3) following chemotherapy. Furthermore events of febrile neutropenia were more frequently encountered in patients with BMI. We conclude that BMI in patients with NHL is a risk factor for chemotherapy induced neutropenia and fever. The role of colony stimulating factors, administered in an attempt to prevent this complication, should be explored.
authors.affiliation: Department of Hematology, Meir Hospital, Kfar Saba, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Kitay-Cohen
authors.forename: M
authors.initials: M
authors.lastname: Lishner
authors.forename: A
authors.initials: A
authors.lastname: Shelef
authors.forename: M
authors.initials: M
authors.lastname: Ravid
authors.forename: Y
authors.initials: Y
authors.lastname: Manor
mesh_terms: D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000209:etiology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012307:Risk Factors