title: The need for improved neutropenia risk assessment in DLBCL patients receiving R-CHOP-21: findings from clinical practice.
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.
authors.affiliation: Haematology Department, Hospital del Mar, Barcelona, Spain. asalar@hospitaldelmar.cat
authors.forename: Antonio
authors.initials: A
authors.lastname: Salar
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Francesca G
authors.initials: FG
authors.lastname: Rossi
authors.forename: Ulrich
authors.initials: U
authors.lastname: Duehrsen
authors.forename: Ruth
authors.initials: R
authors.lastname: Pettengell
authors.forename: Hans E
authors.initials: HE
authors.lastname: Johnsen
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jaeger
authors.forename: Gregor
authors.initials: G
authors.lastname: Verhoef
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwenkglenks
authors.forename: Pamela
authors.initials: P
authors.lastname: Bacon
authors.forename: Kate
authors.initials: K
authors.lastname: Bendall
authors.forename: Pieternella J
authors.initials: PJ
authors.lastname: Lugtenburg
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000139:chemically induced*; D011241:Prednisone / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D000069283:Rituximab; D014750:Vincristine / Q000009:adverse effects
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D016179:Granulocyte Colony-Stimulating Factor; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone