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

Michael Roost Clausen*, Sinna Pilgaard Ulrichsen, Thomas Stauffer Larsen, Christian B. Poulsen, Selma Tojaga, Per Trøllund Pedersen, Jakob Madsen, Robert Schou Pedersen, Pär Lars Josefsson, Jette Sønderskov Gørløv, Mette Nørgaard, Francesco d’Amore

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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.

Original languageEnglish
JournalLeukemia and Lymphoma
Volume60
Issue number8
Pages (from-to)1950-1957
ISSN1042-8194
DOIs
Publication statusPublished - 3. Jul 2019

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Keywords

  • Diffuse large B-cell lymphoma
  • neutropenia
  • prognosis

Cite this

Clausen, M. R., Ulrichsen, S. P., Larsen, T. S., Poulsen, C. B., Tojaga, S., Pedersen, P. T., Madsen, J., Pedersen, R. S., Josefsson, P. L., Gørløv, J. S., Nørgaard, M., & d’Amore, F. (2019). Depth of neutrophil nadir after first cycle of R-CHOP predicts outcome in diffuse large B-cell lymphoma–a nationwide population-based cohort study. Leukemia and Lymphoma, 60(8), 1950-1957. https://doi.org/10.1080/10428194.2018.1554863