Factors Associated with Chemotherapy-Induced Neutropenia in Diffuse Large B-Cell Lymphoma Patients Undergoing Combination Chemotherapy: A Case-Control Study
Keywords:
Diffuse large B-cell lymphoma, Chemotherapy-induced febrile neutropenia, Precipitating factorsAbstract
Purpose: This study aimed to identify the factors associated with chemotherapy-induced neutropenia (CIN) in diffuse large B-cell lymphoma (DLBCL) patients undergoing combination chemotherapy. Methods: A total of 111 patients with DLBCL participated in this study at C University Hospital. The CIN group consisted of patients with an absolute neutrophil count (ANC) lower than 1,000 cells/μL. Clinical factors, the level of depression, and the level of healthy lifestyle were measured on the chemotherapy administration day, and the ANC was measured on the next follow-up day. Results: Binary logistic regression analysis showed that the factors associated with CIN in DLBCL were the presence of B symptoms at diagnosis (β = 4.69) and low-risk CIN regimen (β = 0.10) among clinical factors, and the level of healthy lifestyle (β = 0.17). Conclusion: Oncology nurses should focus on the patients vulnerable to CIN having B symptoms at diagnosis, receiving a low-risk CIN regimen, and showing non-adherence to healthy lifestyle practice. Administration of granulocyte colony-stimulating factor can be considered for the patients receiving low-risk CIN regimen to reduce CIN. Education programs including healthy lifestyle practice for improving the immune system should be applied to DLBCL patients.
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