Patterns of growth factor usage and febrile neutropenia among older patients with diffuse large B-cell non-Hodgkin lymphoma treated with CHOP or R-CHOP: the Intergroup experience (CALGB 9793; ECOG-SWOG 4494)

Vicki A. Morrison, Edie A. Weller, Thomas Matthew Habermann, Shuli Li, Richard I. Fisher, Bruce D. Cheson, Bruce A. Peterson

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Patterns of myeloid growth factor (GF) usage and febrile neutropenia (FN) were examined in patients >60 years of age with diffuse large B-cell non-Hodgkin lymphoma (DLBCL) enrolled on CALGB 9793/ECOG-SWOG 4494, receiving initial therapy with cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or rituximab + CHOP (R-CHOP). Myeloid GFs were administered to 256/520 (49%) patients. Indications for use were: prevent dose reduction/dose delay (81%, 207/256); treat FN or non-febrile neutropenia (NFN) (19%, 48/256). One or more FN episodes occurred in 41% (212/520) of patients, with FN most often in cycle 1 (38% of episodes). In multivariate analysis, risk factors for FN included age >65 years (odds ratio (OR) = 2.6, 95% CI: [1.4, 4.9]) and anemia (hemoglobin <12 g/dl) (OR =2.2, 95% confidence intervals (CI): [1.4, 3.5]. Myeloid GF use was common in this older DLBCL population receiving CHOP-based therapy, as was FN, especially during cycle one. Risk factors predictive for FN should be used prospectively to identify patients for whom myeloid GFs are best utilized.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Dec 14 2016

Fingerprint

Febrile Neutropenia
B-Cell Lymphoma
Non-Hodgkin's Lymphoma
Intercellular Signaling Peptides and Proteins
Odds Ratio
Confidence Intervals
Vincristine
Prednisone
Rituximab
Neutropenia
Doxorubicin
Cyclophosphamide
Anemia
Hemoglobins
Multivariate Analysis
Therapeutics
Population

Keywords

  • diffuse large B-cell lymphoma
  • elderly
  • Lymphoma
  • myeloid growth factor
  • neutropenia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Patterns of growth factor usage and febrile neutropenia among older patients with diffuse large B-cell non-Hodgkin lymphoma treated with CHOP or R-CHOP : the Intergroup experience (CALGB 9793; ECOG-SWOG 4494). / Morrison, Vicki A.; Weller, Edie A.; Habermann, Thomas Matthew; Li, Shuli; Fisher, Richard I.; Cheson, Bruce D.; Peterson, Bruce A.

In: Leukemia and Lymphoma, 14.12.2016, p. 1-9.

Research output: Contribution to journalArticle

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abstract = "Patterns of myeloid growth factor (GF) usage and febrile neutropenia (FN) were examined in patients >60 years of age with diffuse large B-cell non-Hodgkin lymphoma (DLBCL) enrolled on CALGB 9793/ECOG-SWOG 4494, receiving initial therapy with cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or rituximab + CHOP (R-CHOP). Myeloid GFs were administered to 256/520 (49{\%}) patients. Indications for use were: prevent dose reduction/dose delay (81{\%}, 207/256); treat FN or non-febrile neutropenia (NFN) (19{\%}, 48/256). One or more FN episodes occurred in 41{\%} (212/520) of patients, with FN most often in cycle 1 (38{\%} of episodes). In multivariate analysis, risk factors for FN included age >65 years (odds ratio (OR) = 2.6, 95{\%} CI: [1.4, 4.9]) and anemia (hemoglobin <12 g/dl) (OR =2.2, 95{\%} confidence intervals (CI): [1.4, 3.5]. Myeloid GF use was common in this older DLBCL population receiving CHOP-based therapy, as was FN, especially during cycle one. Risk factors predictive for FN should be used prospectively to identify patients for whom myeloid GFs are best utilized.",
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