title: [Impact of early lymphopenia on the risk of febrile neutropenia and hematological toxicity].
abstract: BACKGROUND
  Hematologic toxicity is a severe complication of chemotherapy. The objective of our study is to evaluate the impact of early lymphopenia on the risk of occurrence of febrile neutropenia and hematological toxicity after aggressive chemotherapy for Hodgkin lymphoma or high grade non-Hodgkin lymphoma.
  
  
  METHODS
  This prospective study involved 42 patients who received 193 cycles of chemotherapy in 2009. We assessed the impact of lymphopenia on day 1 and 8 on the risk of occurrence of febrile neutropenia. We also investigated the relation between the occurrence of hematologic toxicity after the first cycle and the subsequent cycles.
  
  
  RESULTS
  Febrile neutropenia was observed in 25% of cycles. Grade 3/4 hematologic toxicity occurred in 63% of cycles. Growth factors were used in 79% of cycles. Lymphopenia ≤ 700/mm3 on day1 and 8 was noted in 21% and 65% of cycles. If the lymphocyte count was ≤700/mm3 on day1, the risk of febrile neutropenia was significantly higher (p=0.042) and the mean duration of antibiotic therapy longer (p = 0.013). Lymphopenia ≤700/mm3 on day 8 was associated with a greater risk of febrile neutropenia in univariate analysis (OR=2.4; p=0.02). Moreover analyzes showed that this factor was significantly associated with increase in hematologic toxicity (p=0.02), duration of neutropenia (p=0.001) and duration of antibiotics (p=0.05). Hematologic toxicity during the first cycle was predictive of its occurrence in subsequent cycles of chemotherapy (p=0.028).
  
  
  CONCLUSIONS
  Our results confirmed the impact of early lymphopenia on the occurrence of febrile neutropenia and hematologic toxicity after aggressive chemotherapy for Hodgkin lymphoma or high grade non Hodgkin lymphoma.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ben Nasr
authors.forename: Sami
authors.initials: S
authors.lastname: Zriba
authors.forename: Karima
authors.initials: K
authors.lastname: Kacem
authors.forename: Yosra
authors.initials: Y
authors.lastname: Yahyaoui
authors.forename: Houda
authors.initials: H
authors.lastname: El Benna
authors.forename: Raoudha
authors.initials: R
authors.lastname: Mansouri
authors.forename: Rayhane
authors.initials: R
authors.lastname: Ben Lakhal
authors.forename: Balkis
authors.initials: B
authors.lastname: Meddeb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008231:Lymphopenia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents