Annals of Oncology Advance Access originally published online on November 1, 2006
Annals of Oncology 2007 18(2):364-369; doi:10.1093/annonc/mdl393
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© 2006 European Society for Medical Oncology
hematologic malignancies |
A high incidence of late-onset neutropenia following rituximab-containing chemotherapy as a primary treatment of CD20-positive B-cell lymphoma: a single-institution study
1 Department of Hematology and Oncology
2 Department of Transfusion Medicine and Immunohematology, Graduate School of Medicine, University of Tokyo
3 Department of Pathology, Toranomon Hospital
4 Department of Pathology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan
* Correspondence to: Prof M. Kurokawa, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Tel: +81-3-5800-6527; Fax: +81-3-3815-8350; E-mail: kurokawa-tky{at}umin.ac.jp
Background: Late-onset neutropenia (LON) has been reported following rituximab-containing chemotherapy. Its incidence and risk factors, however, have not been extensively studied.
Patients and methods: We retrospectively reviewed the medical records of 107 patients treated with rituximab-containing chemotherapy as a primary treatment of CD20-positive B-cell lymphomas and identified cases with LON as defined by the neutrophil count of 
1.0 x 109/l without an apparent cause after the recovery of neutrophil count following completion of the intended chemotherapy.
Results: With a median follow-up of 411 days, 23 patients developed LON out of the 107 at a median of 106 days after the last chemotherapy. Cumulative incidence of LON among the total patients was 24.9%. The median neutrophil count nadir was 0.61 x 109/l. The LON episodes were generally self-limited, and filgrastim was administered in one patient. Including this patient, there were no serious infectious episodes in the cases with LON. In multivariate analysis, intensive chemotherapy regimens including high-dose therapy followed by autologous hematopoietic stem cell transplantation (ASCT) and high-dose methotrexate-containing regimens without ASCT were a risk factor for LON.
Conclusion: This study suggests that LON is a frequent complication of rituximab-containing intensive chemotherapy.
Key words: late-onset neutropenia, lymphoma, neutropenia, rituximab
These authors contributed equally to this work. Received for publication August 1, 2006. Revision received September 12, 2006. Accepted for publication September 14, 2006.
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