Depth of neutrophil nadir after first cycle of R-CHOP predicts outcome in diffuse large B-cell lymphoma - a nationwide population-based cohort study

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  • Michael Roost Clausen
  • Sinna Pilgaard Ulrichsen
  • Thomas Stauffer Larsen, Department of Hematology and the Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, DK-5000, Odense C, Denmark.
  • ,
  • Christian B Poulsen
  • Selma Tojaga, e Department of Hematology , Sygehus Lillebaelt , Vejle , Denmark.
  • ,
  • Per Trøllund Pedersen, f Department of Hematology , Sydvestjysk Sygehus , Esbjerg , Denmark.
  • ,
  • Jakob Madsen, g Department of Hematology , Aalborg University Hospital , Aalborg , Denmark.
  • ,
  • Robert Schou Pedersen, h Department of Medicine , Hospitalsenheden Vest , Holstebro , Denmark.
  • ,
  • Pär Lars Josefsson, i Department of Hematology, Herlev Hospital , Herlev , Denmark.
  • ,
  • Jette Sønderskov Gørløv, j Department of Hematology , Rigshospitalet , Copenhagen , Denmark.
  • ,
  • Mette Nørgaard, b Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
  • ,
  • Francesco d'Amore

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.

Original languageEnglish
JournalLeukemia and Lymphoma
Pages (from-to)1-8
Number of pages8
ISSN1042-8194
DOIs
Publication statusPublished - 22 Jan 2019

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