Severe neutropenia and relative dose intensity among patients <65 and ≥65 years with non-Hodgkin's lymphoma receiving CHOP-based chemotherapy

Lee Schwartzberg, Mansoor Saleh, Sadie Whittaker, Esteban Abella

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: The objective of this study was to describe the incidence of grade 3/4 neutropenia, patterns of chemotherapy treatment, and granulocyte colony-stimulating factor (G-CSF) use patterns among patients with non-Hodgkin's lymphoma (NHL) <65 and ≥65 years. Methods: This retrospective, observational study included adult patients with NHL who received cyclophosphamide, doxorubicin, vincristine, and prednisone±rituximab (CHOP±R) from January 2006 to June 2010. Results: A total of 1,579 patients were included, with 54.1 % <65 years and 45.9 % ≥65 years. Most received CHOP-R on a Q3W schedule. Among patients <65 years, the incidence of grade 3/4 neutropenia was 52.3 %, the mean relative dose intensity (RDI) was 80.4 %, and the incidences of dose delays and reductions were 26.5 and 9.6 %, respectively. Among patients ≥65 years, the incidence of grade 3/4 neutropenia was 63.2 %, the mean RDI was 73.9 %, and the incidences of dose delays and reductions were 24.6 and 24.9 %, respectively. Most patients (86.9 %) received G-CSF. Among patients <65 years, 71.9, 17.4, and 10.7 % first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Among patients ≥65 years, 80.1, 11.6, and 8.3 % first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Conclusions: Chemotherapy regimens and schedules were similar among age groups. Grade 3/4 neutropenia, reduced RDI, and dose delays were common in both age groups, though patients ≥65 years had a higher incidence of dose reductions. In spite of these similarities, patients <65 years were less likely to receive primary prophylactic G-CSF. Thus, careful assessment of neutropenia risk factors is needed across age groups to determine appropriate G-CSF use and support planned chemotherapy.

Original languageEnglish (US)
Pages (from-to)1833-1841
Number of pages9
JournalSupportive Care in Cancer
Volume22
Issue number7
DOIs
StatePublished - Jan 1 2014

Fingerprint

Neutropenia
Non-Hodgkin's Lymphoma
Drug Therapy
Granulocyte Colony-Stimulating Factor
Incidence
Age Groups
Appointments and Schedules
Vincristine
Doxorubicin
Cyclophosphamide
Observational Studies
Therapeutics
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Severe neutropenia and relative dose intensity among patients <65 and ≥65 years with non-Hodgkin's lymphoma receiving CHOP-based chemotherapy. / Schwartzberg, Lee; Saleh, Mansoor; Whittaker, Sadie; Abella, Esteban.

In: Supportive Care in Cancer, Vol. 22, No. 7, 01.01.2014, p. 1833-1841.

Research output: Contribution to journalArticle

@article{daa0d32125a64605b8134f530f73c303,
title = "Severe neutropenia and relative dose intensity among patients <65 and ≥65 years with non-Hodgkin's lymphoma receiving CHOP-based chemotherapy",
abstract = "Purpose: The objective of this study was to describe the incidence of grade 3/4 neutropenia, patterns of chemotherapy treatment, and granulocyte colony-stimulating factor (G-CSF) use patterns among patients with non-Hodgkin's lymphoma (NHL) <65 and ≥65 years. Methods: This retrospective, observational study included adult patients with NHL who received cyclophosphamide, doxorubicin, vincristine, and prednisone±rituximab (CHOP±R) from January 2006 to June 2010. Results: A total of 1,579 patients were included, with 54.1 {\%} <65 years and 45.9 {\%} ≥65 years. Most received CHOP-R on a Q3W schedule. Among patients <65 years, the incidence of grade 3/4 neutropenia was 52.3 {\%}, the mean relative dose intensity (RDI) was 80.4 {\%}, and the incidences of dose delays and reductions were 26.5 and 9.6 {\%}, respectively. Among patients ≥65 years, the incidence of grade 3/4 neutropenia was 63.2 {\%}, the mean RDI was 73.9 {\%}, and the incidences of dose delays and reductions were 24.6 and 24.9 {\%}, respectively. Most patients (86.9 {\%}) received G-CSF. Among patients <65 years, 71.9, 17.4, and 10.7 {\%} first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Among patients ≥65 years, 80.1, 11.6, and 8.3 {\%} first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Conclusions: Chemotherapy regimens and schedules were similar among age groups. Grade 3/4 neutropenia, reduced RDI, and dose delays were common in both age groups, though patients ≥65 years had a higher incidence of dose reductions. In spite of these similarities, patients <65 years were less likely to receive primary prophylactic G-CSF. Thus, careful assessment of neutropenia risk factors is needed across age groups to determine appropriate G-CSF use and support planned chemotherapy.",
author = "Lee Schwartzberg and Mansoor Saleh and Sadie Whittaker and Esteban Abella",
year = "2014",
month = "1",
day = "1",
doi = "10.1007/s00520-014-2157-8",
language = "English (US)",
volume = "22",
pages = "1833--1841",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",
number = "7",

}

TY - JOUR

T1 - Severe neutropenia and relative dose intensity among patients <65 and ≥65 years with non-Hodgkin's lymphoma receiving CHOP-based chemotherapy

AU - Schwartzberg, Lee

AU - Saleh, Mansoor

AU - Whittaker, Sadie

AU - Abella, Esteban

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: The objective of this study was to describe the incidence of grade 3/4 neutropenia, patterns of chemotherapy treatment, and granulocyte colony-stimulating factor (G-CSF) use patterns among patients with non-Hodgkin's lymphoma (NHL) <65 and ≥65 years. Methods: This retrospective, observational study included adult patients with NHL who received cyclophosphamide, doxorubicin, vincristine, and prednisone±rituximab (CHOP±R) from January 2006 to June 2010. Results: A total of 1,579 patients were included, with 54.1 % <65 years and 45.9 % ≥65 years. Most received CHOP-R on a Q3W schedule. Among patients <65 years, the incidence of grade 3/4 neutropenia was 52.3 %, the mean relative dose intensity (RDI) was 80.4 %, and the incidences of dose delays and reductions were 26.5 and 9.6 %, respectively. Among patients ≥65 years, the incidence of grade 3/4 neutropenia was 63.2 %, the mean RDI was 73.9 %, and the incidences of dose delays and reductions were 24.6 and 24.9 %, respectively. Most patients (86.9 %) received G-CSF. Among patients <65 years, 71.9, 17.4, and 10.7 % first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Among patients ≥65 years, 80.1, 11.6, and 8.3 % first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Conclusions: Chemotherapy regimens and schedules were similar among age groups. Grade 3/4 neutropenia, reduced RDI, and dose delays were common in both age groups, though patients ≥65 years had a higher incidence of dose reductions. In spite of these similarities, patients <65 years were less likely to receive primary prophylactic G-CSF. Thus, careful assessment of neutropenia risk factors is needed across age groups to determine appropriate G-CSF use and support planned chemotherapy.

AB - Purpose: The objective of this study was to describe the incidence of grade 3/4 neutropenia, patterns of chemotherapy treatment, and granulocyte colony-stimulating factor (G-CSF) use patterns among patients with non-Hodgkin's lymphoma (NHL) <65 and ≥65 years. Methods: This retrospective, observational study included adult patients with NHL who received cyclophosphamide, doxorubicin, vincristine, and prednisone±rituximab (CHOP±R) from January 2006 to June 2010. Results: A total of 1,579 patients were included, with 54.1 % <65 years and 45.9 % ≥65 years. Most received CHOP-R on a Q3W schedule. Among patients <65 years, the incidence of grade 3/4 neutropenia was 52.3 %, the mean relative dose intensity (RDI) was 80.4 %, and the incidences of dose delays and reductions were 26.5 and 9.6 %, respectively. Among patients ≥65 years, the incidence of grade 3/4 neutropenia was 63.2 %, the mean RDI was 73.9 %, and the incidences of dose delays and reductions were 24.6 and 24.9 %, respectively. Most patients (86.9 %) received G-CSF. Among patients <65 years, 71.9, 17.4, and 10.7 % first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Among patients ≥65 years, 80.1, 11.6, and 8.3 % first received G-CSF as primary prophylaxis, secondary prophylaxis, or treatment, respectively. Conclusions: Chemotherapy regimens and schedules were similar among age groups. Grade 3/4 neutropenia, reduced RDI, and dose delays were common in both age groups, though patients ≥65 years had a higher incidence of dose reductions. In spite of these similarities, patients <65 years were less likely to receive primary prophylactic G-CSF. Thus, careful assessment of neutropenia risk factors is needed across age groups to determine appropriate G-CSF use and support planned chemotherapy.

UR - http://www.scopus.com/inward/record.url?scp=84902359808&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902359808&partnerID=8YFLogxK

U2 - 10.1007/s00520-014-2157-8

DO - 10.1007/s00520-014-2157-8

M3 - Article

VL - 22

SP - 1833

EP - 1841

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 7

ER -