BACKGROUND: Late-onset neutropenia (LON) has been reported following rituximab-containing chemotherapy. Its incidence and risk factors, however, have not been extensively studied. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 107 patients treated with rituximab-containing chemotherapy as a primary treatment of CD20-positive B-cell lymphomas and identified cases with LON as defined by the neutrophil count of <or=1.0 x 10(9)/l without an apparent cause after the recovery of neutrophil count following completion of the intended chemotherapy. RESULTS: With a median follow-up of 411 days, 23 patients developed LON out of the 107 at a median of 106 days after the last chemotherapy. Cumulative incidence of LON among the total patients was 24.9%. The median neutrophil count nadir was 0.61 x 10(9)/l. The LON episodes were generally self-limited, and filgrastim was administered in one patient. Including this patient, there were no serious infectious episodes in the cases with LON. In multivariate analysis, intensive chemotherapy regimens including high-dose therapy followed by autologous hematopoietic stem cell transplantation (ASCT) and high-dose methotrexate-containing regimens without ASCT were a risk factor for LON. CONCLUSION: This study suggests that LON is a frequent complication of rituximab-containing intensive chemotherapy.
BACKGROUND:Late-onset neutropenia (LON) has been reported following rituximab-containing chemotherapy. Its incidence and risk factors, however, have not been extensively studied. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 107 patients treated with rituximab-containing chemotherapy as a primary treatment of CD20-positive B-cell lymphomas and identified cases with LON as defined by the neutrophil count of <or=1.0 x 10(9)/l without an apparent cause after the recovery of neutrophil count following completion of the intended chemotherapy. RESULTS: With a median follow-up of 411 days, 23 patients developed LON out of the 107 at a median of 106 days after the last chemotherapy. Cumulative incidence of LON among the total patients was 24.9%. The median neutrophil count nadir was 0.61 x 10(9)/l. The LON episodes were generally self-limited, and filgrastim was administered in one patient. Including this patient, there were no serious infectious episodes in the cases with LON. In multivariate analysis, intensive chemotherapy regimens including high-dose therapy followed by autologous hematopoietic stem cell transplantation (ASCT) and high-dose methotrexate-containing regimens without ASCT were a risk factor for LON. CONCLUSION: This study suggests that LON is a frequent complication of rituximab-containing intensive chemotherapy.
Authors: Y L Kasamon; R J Jones; R A Brodsky; E J Fuchs; W Matsui; L Luznik; J D Powell; A L Blackford; A Goodrich; C D Gocke; R A Abrams; R F Ambinder; I W Flinn Journal: Ann Oncol Date: 2009-10-30 Impact factor: 32.976
Authors: Daniel Tesfa; Tobias Gelius; Birgitta Sander; Eva Kimby; Bengt Fadeel; Jan Palmblad; Hans Hägglund Journal: Med Oncol Date: 2008-02-16 Impact factor: 3.064
Authors: Yvette L Kasamon; Robert A Brodsky; Michael J Borowitz; Richard F Ambinder; Pamela A Crilley; Steve Y Cho; Hua-ling Tsai; B Douglas Smith; Douglas E Gladstone; Hetty E Carraway; Carol Ann Huff; William H Matsui; Javier Bolaños-Meade; Richard J Jones; Lode J Swinnen Journal: Leuk Lymphoma Date: 2012-08-17
Authors: Paul M Barr; Pingfu Fu; Hillard M Lazarus; Nancy Horvath; Stanton L Gerson; Omer N Koc; Nizar J Bahlis; Michael R Snell; Afshin Dowlati; Brenda W Cooper Journal: Br J Haematol Date: 2009-06-29 Impact factor: 6.998