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Depth of neutrophil nadir after first cycle of R-CHOP predicts outcome in diffuse large B-cell lymphoma - a nationwide population-based cohort study.
- Source :
-
Leukemia & lymphoma [Leuk Lymphoma] 2019 Aug; Vol. 60 (8), pp. 1950-1957. Date of Electronic Publication: 2019 Jan 22. - Publication Year :
- 2019
-
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 (10 <superscript>9</superscript> /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.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Comorbidity
Cyclophosphamide
Denmark epidemiology
Doxorubicin
Female
Humans
Lymphoma, Large B-Cell, Diffuse drug therapy
Male
Middle Aged
Neutropenia epidemiology
Neutropenia etiology
Population Surveillance
Prednisone
Prognosis
Rituximab
Survival Analysis
Treatment Outcome
Vincristine
Young Adult
Leukocyte Count
Lymphoma, Large B-Cell, Diffuse blood
Lymphoma, Large B-Cell, Diffuse epidemiology
Neutrophils pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1029-2403
- Volume :
- 60
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Leukemia & lymphoma
- Publication Type :
- Academic Journal
- Accession number :
- 30668181
- Full Text :
- https://doi.org/10.1080/10428194.2018.1554863