TY - JOUR
T1 - Depth of neutrophil nadir after first cycle of R-CHOP predicts outcome in diffuse large B-cell lymphoma - a nationwide population-based cohort study
AU - Clausen, Michael Roost
AU - Ulrichsen, Sinna Pilgaard
AU - Larsen, Thomas Stauffer
AU - Poulsen, Christian B
AU - Tojaga, Selma
AU - Pedersen, Per Trøllund
AU - Madsen, Jakob
AU - Pedersen, Robert Schou
AU - Josefsson, Pär Lars
AU - Gørløv, Jette Sønderskov
AU - Nørgaard, Mette
AU - d'Amore, Francesco
PY - 2019/8
Y1 - 2019/8
N2 - We investigated if survival was predicted by nadir neutrophil counts after the first cycle of R-CHOP in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Neutrophil counts (109/L) were categorized in four grades in the nadir time frame. Prognostic indices and comorbidity levels were calculated and used to adjust the Cox regression model. Kaplan-Meier and Cox regression methods were used to estimate and compare survival. We identified 965 patients. Grade 4 neutropenia was present in 432 (45%). Grade 0 patients had a 5-year overall survival of 67%, grade 1-2: 78%, grade 3: 64%, and grade 4: 57%. Compared with grade 0 adjusted hazard ratios (HR) for death were: 0.77 (95% CI 0.49-1.21) for grade 1-2, 1.18 (95% CI 0.82-1.71) for grade 3, and 1.33 (95% CI 1.02-1.73) for grade 4. Grade 4 neutropenia after the 1st cycle of chemotherapy predicted inferior outcome compared with grade 0 and 1-2. Grade 1-2 neutropenia seemed to have superior outcome.
AB - We investigated if survival was predicted by nadir neutrophil counts after the first cycle of R-CHOP in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Neutrophil counts (109/L) were categorized in four grades in the nadir time frame. Prognostic indices and comorbidity levels were calculated and used to adjust the Cox regression model. Kaplan-Meier and Cox regression methods were used to estimate and compare survival. We identified 965 patients. Grade 4 neutropenia was present in 432 (45%). Grade 0 patients had a 5-year overall survival of 67%, grade 1-2: 78%, grade 3: 64%, and grade 4: 57%. Compared with grade 0 adjusted hazard ratios (HR) for death were: 0.77 (95% CI 0.49-1.21) for grade 1-2, 1.18 (95% CI 0.82-1.71) for grade 3, and 1.33 (95% CI 1.02-1.73) for grade 4. Grade 4 neutropenia after the 1st cycle of chemotherapy predicted inferior outcome compared with grade 0 and 1-2. Grade 1-2 neutropenia seemed to have superior outcome.
KW - Diffuse large B-cell lymphoma
KW - neutropenia
KW - prognosis
U2 - 10.1080/10428194.2018.1554863
DO - 10.1080/10428194.2018.1554863
M3 - Article
C2 - 30668181
SN - 1042-8194
VL - 60
SP - 1950
EP - 1957
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 8
ER -