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Hematology. 2013 May;18(3):131-7. doi: 10.1179/1607845412Y.0000000049. Epub 2012 Nov 19.

Neutropenia and G-CSF in lymphoproliferative diseases.

Author information

1
University of Bari Aldo Moro Medical School, Piazza Giulio Cesare 11, Bari, Italy. ria@dimo.uniba.it

Abstract

BACKGROUND:

Chemotherapy-induced neutropenia is a major cause of morbidity and mortality. It frequently causes dose reductions or treatment delay, which can be prevented or treated by the administration of granulocyte-colony-stimulating factor (G-CSF). However, a better knowledge of the incidence, day of onset after therapy, and duration of neutropenia is essential to optimize the use of G-CSF.

DESIGN AND METHODS:

Six hundred and ninety-four patients from a single institution, affected by lympho-proliferative diseases, were retrospectively reviewed for the occurrence of grade 4 neutropenia and febrile neutropenia (FN). Duration of neutropenia and time of neutrophil nadir were also retrieved. The diagnoses included non-Hodgkin's lymphoma, Hodgkin's lymphoma, and multiple myeloma. Chemotherapy regimens were obviously different according to the diagnosis, disease stage, and first or subsequent lines of therapy.

RESULTS:

No patient received G-CSF as primary prophylaxis. Median nadir did not significantly differ among patients treated with first or successive lines of therapy. The incidence of grade 4 neutropenia and FN ranged from 0 to 94%, depending on the chemotherapy regimen. Patients receiving a first-line chemotherapy regimen had a significantly lower incidence of febrile grade 4 neutropenia compared to patients treated with a second or subsequent line of therapy. The duration of grade 4 neutropenia was significantly longer in patients given second or subsequent lines.

CONCLUSION:

The results of this study could be useful to define the nadir onset in the hematologic setting in order to correctly tailor timing and duration of G-CSF prophylaxis and to assess the lowest fully effective dose.

PMID:
23321273
PMCID:
PMC3648783
DOI:
10.1179/1607845412Y.0000000049
[Indexed for MEDLINE]
Free PMC Article
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