MO2-9-4Incidence, risk factors and clinical features of febrile neutropenia in malignant lymphoma patients in our institution

Abstract Background Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) is the standard treatment regimen for malignant lymphoma. CHOP-induced neutropenia is a common clinical complication that often develops into life-threatening febrile neutropenia (FN). The incidence rate of FN in malignant lymphoma patients receiving a CHOP + rituximab regimen is approximately 10%–20% in clinical trials. Assessing FN-related factors in an individual hospital is an important step towards ensuring appropriate treatment. Therefore, we aimed to evaluate the incidence, risk factors, and clinical features related to FN in our institution and to determine the rate of treatment success in FN patients receiving antibiotics. Methods FN-related characteristics were investigated in 182 malignant lymphoma patients who were treated with the CHOP regimen between January 2013 and December 2018. All data were retrospectively collected from the electronic medical record system. Categorical factors were compared using the Fisher’s exact test and Mann-Whitney U test. Logistic regression analysis was used to analyze FN-related risk factors. Results Among 182 patients, 79 (43.4%) were men. Median age was 67 years. Most patients (90.7%) had an Eastern Cooperative Oncology Group performance status (PS) of 0–2. We noted 80 FN episodes in 60 patients (33.0%). On multivariate analysis, lack of granulocyte colony stimulating factor (G-CSF) prophylaxis in cycle 1 and poor PS were significantly associated with FN occurrence. Documented infections were observed in case of 35 FN episodes (43.8%), and median fever duration was 3 days. Treatment was successful without any modifications in case of 64 episodes (80%). No deaths were observed. Conclusion FN incidence was 33.3% at our institution. Lack of G-CSF prophylaxis and poor performance status were risk factors for FN in this setting. Use of G-CSF prophylaxis in patients with poor PS may help in decreasing FN incidence.