Risk factors for neutropenia in patients with non-Hodgkin B-Cell lymphoma after chemotherapy and their relationship with outcomes

doi:10.3877/cma.j.issn.1674-0785.2022.10.011

Abstract

Abstract:

Objective

To identify potential risk factors for the occurrence of neutropenia and infection in patients diagnosed with B-cell lymphoma, and explore their relationship with outcomes of chemotherapy.

Methods

Patients with non-Hodgkin B-cell lymphoma who were treated at the Department of Oncology and Hematology, Tsinghua Chang Gung Hospital, Beijing from June 2016 to June 2021 were included. The chemotherapy regimens were generally based on the standard R-CHOP regimen. The factors analyzed in the study included gender, age at first diagnosis, body mass index, tumor stage & group, the presence of hepatitis B or not, chemotherapy courses, whether neutropenia occurred during the present chemotherapy course and its cumulative duration, whether there was severe infection, and baseline laboratory test indicators. The analyses were performed by mixed effects and binary logistic regression.

Results

Among the 253 times of chemotherapy in 39 patients, 58.97% had neutropenia. Hepatitis B and stage IV were the risk factors for neutropenia and its prolongation. Hepatitis B was also a risk factor for serious infection. Neutropenia and its prolonged duration were risk factors for poor treatment outcome.

Conclusion

Hepatitis B and stage IV may be risk factors for agranulocytosis during chemotherapy in patients with B-cell lymphoma, and may lead to poor chemotherapy outcomes.

Key words: B-cell lymphoma, Neutropenia, Infection, Chemotherapy effect

Jingxian Li, Yanying Wang, Jiao Li, Lihong Li. Risk factors for neutropenia in patients with non-Hodgkin B-Cell lymphoma after chemotherapy and their relationship with outcomes[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(10): 982-988.

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References 26

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因变量	统计结果	性别^a	分期为Ⅲ期^b	分期为Ⅳ期^b	分组^c	是否罹患乙肝^d	初诊年龄	BMI
A：是否发生中性粒细胞缺乏	OR值	0.465	2.307	3.359	1.160	7.316	1.009	0.877
	标准差	0.217	1.515	1.935	0.482	3.663	0.016	0.06
	P值	0.101	0.203	0.035	0.721	＜0.001	0.559	0.057
B：中性粒细胞缺乏持续时间	OR值	0.422	1.955	3.365	1.153	7.778	1.006	0.893
	标准差	0.202	1.321	1.955	0.484	3.961	0.016	0.062
	P值	0.071	0.321	0.037	0.735	＜0.001	0.713	0.101
C：是否发生严重感染	OR值	0.243	4.002	1.710	2.400	4.660	1.012	0.783
	标准差	0.163	3.335	1.250	1.440	3.216	0.020	0.076
	P值	0.035	0.096	0.463	0.144	0.026	0.558	0.012

因变量	统计结果	性别^a	分期为Ⅲ期^b	分期为Ⅳ期^b	分组^c	是否罹患乙肝^d	初诊年龄	BMI
A：是否发生中性粒细胞缺乏	OR值	0.465	2.307	3.359	1.160	7.316	1.009	0.877
	标准差	0.217	1.515	1.935	0.482	3.663	0.016	0.06
	P值	0.101	0.203	0.035	0.721	＜0.001	0.559	0.057
B：中性粒细胞缺乏持续时间	OR值	0.422	1.955	3.365	1.153	7.778	1.006	0.893
	标准差	0.202	1.321	1.955	0.484	3.961	0.016	0.062
	P值	0.071	0.321	0.037	0.735	＜0.001	0.713	0.101
C：是否发生严重感染	OR值	0.243	4.002	1.710	2.400	4.660	1.012	0.783
	标准差	0.163	3.335	1.250	1.440	3.216	0.020	0.076
	P值	0.035	0.096	0.463	0.144	0.026	0.558	0.012

纳入研究的分类变量	有效	无效	χ²值	P值
性别			0.469	0.667
男性	16（88.89%）	2（11.11%）
女性	17（80.95%）	4（19.05%）
分期			1.547	0.534
Ⅱ	11（91.67%）	1（8.33%）
Ⅲ	9（90%）	1（10%）
Ⅳ	13（76.47%）	4（23.53%）
分组			1.536	0.374
A组	20（90.91%）	2（9.09%）
B组	13（76.47%）	4（23.53%）
是否发生中性粒细胞缺乏			4.933	0.031
无	16（100%）	0
有	17（73.91%）	6（26.09%）
是否发生过严重感染			0.399	0.658
无	21（87.50%）	3（12.50%）
有	12（80%）	3（20%）

纳入研究的分类变量	有效	无效	χ²值	P值
性别			0.469	0.667
男性	16（88.89%）	2（11.11%）
女性	17（80.95%）	4（19.05%）
分期			1.547	0.534
Ⅱ	11（91.67%）	1（8.33%）
Ⅲ	9（90%）	1（10%）
Ⅳ	13（76.47%）	4（23.53%）
分组			1.536	0.374
A组	20（90.91%）	2（9.09%）
B组	13（76.47%）	4（23.53%）
是否发生中性粒细胞缺乏			4.933	0.031
无	16（100%）	0
有	17（73.91%）	6（26.09%）
是否发生过严重感染			0.399	0.658
无	21（87.50%）	3（12.50%）
有	12（80%）	3（20%）

变量	OR值	P值
初诊年龄	0.985	0.636
BMI	0.683	0.045
化疗程数	0.994	0.982
中性粒细胞缺乏累计持续时间	1.142	0.049
化疗前ALT	0.999	0.975
化疗前AST	1.010	0.510
化疗前ABL	0.893	0.157
化疗前Cre	0.798	0.054
化疗前eGFR	1.105	0.056
化疗前HGB	0.974	0.313
化疗前LY	0.018	0.038
化疗前LY%	0.161	＜0.001

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