Impact of body mass index on incidence of febrile neutropenia and treatment-related mortality in United States veterans with diffuse large B-cell lymphoma receiving rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

Background: Reactivation of hepatitis B virus (HBV) and hepatitis C virus (HCV) and febrile neutropenia (FN) are common in diffuse large B-cell lymphoma (DLBCL) patients undergoing cyclophosphamide, hydroxyrubicin, Oncovin, and prednisolone (CHOP) or cyclophosphamide, hydroxyrubicin, Oncovin, prednisolone - rituximab containing (R-CHOP) chemotherapy. This ultimately leads to delaying the therapy, increasing hospital stay, and raising the pharmacoeconomic burden on patients. Aim and Objective: The aim of this study was to determine the incidence of HBV and HCV infection and febrile neutropenia in DLBCL patients treated with R-CHOP and CHOP. Methodology: This was an institutional approved study in which patient records from a private hospital, specialized in hematology and oncology (Karachi, Pakistan), were reviewed retrospectively from 2014 to 2016. Patients aged above 18 years with known diagnosis of DLBCL who underwent CHOP-21 or R-CHOP-21 chemotherapy regimen were included. Baseline blood chemistry and liver function tests along with the data regarding HBV (hepatitis B surface antigen [HBsAg], hepatitis B surface antibody [anti-HBs]), HCV (antibody anti-HCV), and febrile neutropenia were collected from patient records. Results: In total, 35 cases of DLBCL were treated during a 3-year period (ie, from 2014 to 2016), of which 16 were on CHOP-21 regimen whereas 19 were treated with R-CHOP-21. Of the 19 patients who underwent R-CHOP chemotherapy, only 2 (10%) patients were HBsAg reactive. Before commencing the second cycle, 2 (10%) patients reported to hospital with fever and had hematological (low neutrophil count) and microbiological ( Escherichia coli) proven febrile neutropenia. The incidence of HBV infection post treatment was lower in group treated with CHOP (1 patient showed HBsAg reactivity).

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PF321 REAL-WORLD TREATMENT PATTERNS OF PATIENTS DIAGNOSED WITH DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) IN THE UNITED STATES (US)

HemaSphere ◽

10.1097/01.hs9.0000559496.29967.d6 ◽

2019 ◽

Vol 3 (S1) ◽

pp. 113

Author(s):

X. Yang ◽

F. Laliberté ◽

G. Germain ◽

M. Raut ◽

M.S. Duh ◽

...

Keyword(s):

United States ◽

B Cell ◽

Real World ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

The United States ◽

Treatment Patterns ◽

Large B Cell Lymphoma ◽

Large B Cell

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Comparative effectiveness of anthracycline-containing chemotherapy in United States veterans age 80 and older with diffuse large B-cell lymphoma

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2015.01.003 ◽

2015 ◽

Vol 6 (3) ◽

pp. 211-218 ◽

Cited By ~ 24

Author(s):

Kenneth R. Carson ◽

Peter Riedell ◽

Ryan Lynch ◽

Chadi Nabhan ◽

Tanya M. Wildes ◽

...

Keyword(s):

United States ◽

B Cell ◽

Comparative Effectiveness ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Large B Cell

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Risk of diffuse large B-cell lymphoma after solid organ transplantation in the United States

American Journal of Hematology ◽

10.1002/ajh.23726 ◽

2014 ◽

Vol 89 (7) ◽

pp. 714-720 ◽

Cited By ~ 26

Author(s):

Todd M. Gibson ◽

Eric A. Engels ◽

Christina A. Clarke ◽

Charles F. Lynch ◽

Dennis D. Weisenburger ◽

...

Keyword(s):

United States ◽

B Cell ◽

Organ Transplantation ◽

Cell Lymphoma ◽

Solid Organ Transplantation ◽

B Cell Lymphoma ◽

The United States ◽

Solid Organ ◽

Large B Cell Lymphoma ◽

Large B Cell

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Disparities in the Early Adoption of Chemoimmunotherapy for Diffuse Large B-cell Lymphoma in the United States

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-12-0466 ◽

2012 ◽

Vol 21 (9) ◽

pp. 1520-1530 ◽

Cited By ~ 49

Author(s):

Christopher R. Flowers ◽

Stacey A. Fedewa ◽

Amy Y. Chen ◽

Loretta J. Nastoupil ◽

Joseph Lipscomb ◽

...

Keyword(s):

United States ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

The United States ◽

Large B Cell Lymphoma ◽

Early Adoption ◽

Large B Cell

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Effect of High Body Mass Index on the Prognosis of Diffuse Large B-Cell Lymphoma

Blood ◽

10.1182/blood.v124.21.5368.5368 ◽

2014 ◽

Vol 124 (21) ◽

pp. 5368-5368

Author(s):

Yukako Hattori ◽

Naoto Tomita ◽

Taisei Suzuki ◽

Yasufumi Ishiyama ◽

Kumiko Kishimoto ◽

...

Keyword(s):

Body Mass Index ◽

Prognostic Factor ◽

B Cell ◽

Body Mass ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Low Bmi ◽

Large B Cell ◽

High Bmi

Abstract Background Obesity has been pointed out as one of the risk factors for the development in several neoplastic diseases including malignant lymphoma. However the impact of obesity on the outcome of malignant diseases is unclear. L.Weiss et al have shown that high body mass index (BMI) is a significantly better prognostic factor in diffuse large B-cell lymphoma (DLBCL) (Increased body mass index is associated with improved overall survival in diffuse large B-cell lymphoma. Annals of Oncology 2014; 25: 171-176.). We evaluated this hypothesis in Japanese patients with DLBCL. Patients and Methods We analyzed 338 patients with newly diagnosed DLBCL who received full-dose (80% or more of the prescribed dose) R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) between April 2003 and December 2009 across 7 institutes. Patients of all stages were treated 6 or 8 cycles of full-dose R-CHOP therapy. All the patients were classified into 2 groups: high BMI (≥25 kg/m2 ) or low BMI (<25 kg/m2). Results The median patient age was 65 years (19–80 years); 192 were men and 146 were women. The median BMI was 22.9 kg/m2 (14.1–40.4 kg/m2); 66 patients (19.5%) were in the high BMI group (median, 27.4 kg/m2) and 272 (80.5%) were in the low BMI group (median, 21.6 kg/m2). The median follow-up of patients who were alive (n = 271) was 67.5 months (12.6–121.8 months). The 5-year progression-free survival (PFS) and overall survival (OS) of the high versus low BMI groups were 63.9% versus 74.0% (P = 0.196) and 77.2% versus 84.2% (P = 0.230), respectively (Figure1,2). Multivariate analysis considering the sex, International Prognostic Index, B symptoms, bulky mass, and BMI showed that high BMI (≥25 kg/m2) was a significant adverse prognostic factor for both OS (hazard ratio [HR], 1.906; 95% confidence interval [CI], 1.08-3.376; P = 0.027) and PFS (HR, 1.710; 95% CI, 1.054-2.774; P = 0.030). Conclusion The results of our study indicated that high BMI was an adverse prognostic factor of DLBCL. It is necessary to investigate BMI and its influence on patient background or treatment in much more cases. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.

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