title: Risk of chemotherapy-induced neutropenic complications when treating patients with non-Hodgkin lymphoma.
abstract: BACKGROUND
  Myelosuppression induced by cancer chemotherapy is associated with considerable morbidity and mortality. Febrile neutropenia (FN) represents an oncologic emergency requiring immediate evaluation and treatment. Resulting chemotherapy dose reductions or delays may compromise disease control and survival. While non-Hodgkin lymphoma (NHL) represents a potentially curable malignancy, there are limited data on the risk of neutropenic complications. This review represents a systematic search and evidence summary of neutropenic complications reported in randomized controlled trials (RCTs) published over the past decade in adults with NHL receiving myelosuppressive chemotherapy.
  
  
  METHODS
  Data captured include the chemotherapy regimen and dosing, the type of NHL, sample size, myeloid growth factor (MGF) use, and myelosuppression including FN and severe neutropenia and infection.
  
  
  CONCLUSIONS
  Rates of neutropenic complications for commonly utilized chemotherapy regimens vary considerably across studies with FN reported in only one-fourth of study arms. Further challenges in interpreting reported rates are the variable and inconsistent use of MGF support and little or no information on delivered chemotherapy dose intensity. Considerable change in regimens, study populations and reporting of neutropenic events as well as the use of MGF was observed over the decade of RCTs reported. Complete and accurate reporting of treatment-related toxicities in patients receiving cancer chemotherapy is essential in both clinical trials and clinical practice.
authors.affiliation: a Hutchinson Institute for Cancer Outcomes Research , Fred Hutchinson Cancer Research Center , Seattle , WA , USA.|b Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA.
authors.forename: Gary H
authors.initials: GH
authors.lastname: Lyman
authors.affiliation: a Hutchinson Institute for Cancer Outcomes Research , Fred Hutchinson Cancer Research Center , Seattle , WA , USA.
authors.forename: Marek S
authors.initials: MS
authors.lastname: Poniewierski
authors.affiliation: a Hutchinson Institute for Cancer Outcomes Research , Fred Hutchinson Cancer Research Center , Seattle , WA , USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Culakova
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D053605:Leukemia Inhibitory Factor / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000378:metabolism; D009503:Neutropenia / Q000139:chemically induced* / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D000970:Antineoplastic Agents; D053605:Leukemia Inhibitory Factor
keywords: Lymphoma; chemotherapy; febrile neutropenia; infection; neutropenia