1. Depth of neutrophil nadir after first cycle of R-CHOP predicts outcome in diffuse large B-cell lymphoma - a nationwide population-based cohort study
- Author
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Jette Sønderskov Gørløv, Mette Nørgaard, Selma Tojaga, Pär Josefsson, Per Trøllund Pedersen, Robert Schou Pedersen, Michael Roost Clausen, Francesco d'Amore, Thomas Stauffer Larsen, Christian Bjørn Poulsen, Sinna Pilgaard Ulrichsen, and Jakob Madsen
- Subjects
Male ,Cancer Research ,Neutrophils ,IMPACT ,Denmark ,medicine.medical_treatment ,MULTICENTER ,Comorbidity ,Gastroenterology ,FEBRILE NEUTROPENIA ,Leukocyte Count ,0302 clinical medicine ,DOSE-ADJUSTED EPOCH ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Aged, 80 and over ,RISK ,Hazard ratio ,DOUBLE-HIT LYMPHOMA ,Hematology ,Diffuse large B-cell lymphoma ,Middle Aged ,CHEMOTHERAPY ,Prognosis ,CANCER ,Treatment Outcome ,Oncology ,Vincristine ,Population Surveillance ,030220 oncology & carcinogenesis ,PHASE-II ,Female ,Lymphoma, Large B-Cell, Diffuse ,Rituximab ,Nadir (topography) ,Adult ,medicine.medical_specialty ,Neutropenia ,Adolescent ,Young Adult ,03 medical and health sciences ,Internal medicine ,Humans ,neutropenia ,RITUXIMAB ,Cyclophosphamide ,Aged ,Chemotherapy ,business.industry ,Proportional hazards model ,medicine.disease ,Survival Analysis ,Lymphoma ,Doxorubicin ,Prednisone ,prognosis ,business ,030215 immunology - Abstract
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.
- Published
- 2019
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