Febrile neutropenia risk factors in actively treated diffuse large B-cell lymphoma patients

IF 0.1 Q4 HEMATOLOGY
M. Bakırtaş, T. Yiğenoğlu, S. Başcı, B. Ulu, S. Yaman, M. Çakar, M. Dal, F. Altuntaş
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Abstract

BACKGROUND: Febrile neutropenia (FN) is a serious problem, especially in hematologic malignancies, and can cause high mortality rates and it occurs in 10%–20% of patients with lymphoma. The aim of this research is to assess the risk factors for FN, and the impact of FN on overall survival (OS) in patients with diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: The study included 263 patients who were diagnosed with DLBCL and treated with mostly R-CHOP-based chemotherapy. Data including gender, age, Ann Arbor stage, International Prognostic Index (IPI) score, immunohistologic subtype, treatment regimens, response to treatment, and any FN episode were recorded. The factors predicting FN were analyzed. RESULTS: Significant predictors of FN were the number of chemotherapy lines received and IPI score. The median OS was significantly different between DLBCL patients who had at least one FN episode during the first-line chemotherapy and those who did not (P < 0,001). Significant predictors of OS in the multivariate analysis were the number of chemotherapy lines received, stage, Eastern Cooperative Oncology Group, and disease status. CONCLUSION: Our study reveals that OS is significantly shorter in patients who had an FN episode than those who did not. Therefore, it is crucial to demonstrate all factors related to FN to prevent FN episodes. In our study, the number of chemotherapy lines received and IPI score was found to be significant predictors of FN. Close follow-up should be done in these patients as the risk of FN is higher.
积极治疗弥漫性大B细胞淋巴瘤患者的发热性中性粒细胞减少症危险因素
背景:发热性中性粒细胞减少症(FN)是一个严重的问题,尤其是在血液系统恶性肿瘤中,它会导致高死亡率,发生在10%-20%的淋巴瘤患者中。本研究的目的是评估FN的危险因素,以及FN对弥漫性大B细胞淋巴瘤(DLBCL)患者总生存期(OS)的影响。材料和方法:该研究包括263名被诊断为DLBCL并接受主要基于R-CHOP的化疗的患者。记录包括性别、年龄、Ann Arbor分期、国际预后指数(IPI)评分、免疫组织学亚型、治疗方案、治疗反应和任何FN发作在内的数据。分析预测FN的因素。结果:FN的重要预测因素是接受化疗的化疗线数和IPI评分。在一线化疗期间至少有一次FN发作的DLBCL患者和没有发生FN发作的患者之间,中位OS有显著差异(P<0.001)。在多变量分析中,OS的重要预测因素是接受化疗的行数、分期、东方肿瘤合作组和疾病状况。结论:我们的研究表明,有FN发作的患者的OS明显短于没有FN发作的病人。因此,证明所有与FN相关的因素对预防FN发作至关重要。在我们的研究中,接受化疗的线数和IPI评分被发现是FN的重要预测因素。由于FN的风险较高,应对这些患者进行密切随访。
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