FREQUENCY AND SEVERITY OF NEUTROPENIA IN DIFFUSE LARGE B-CELL NON HODGKIN’S LYMPHOMA AFTER FIRST CYCLE OF CHEMOTHERAPY COMPRISING CYCLOPHOSPHAMIDE, DOXORUBICIN, VINCRISTINE WITH PREDNISOLON
Abstract
Background: Chemotherapy used for malignant diseases may produce severe neutropenia in first cyclewhich may compel for dose modification and early termination of therapy. This descriptive crosssectional study was planned to see the frequency and severity of neutropenia after first cycle ofchemotherapy comprising cyclophosphamide, doxorubicin, vincristine with prednisolon in patients ofdiffuse large B-cell non Hodgkin's lymphoma presenting at Oncology Department Combined MilitaryHospital Rawalpindi from August 2009 to July 2010. Methods: Thirty patients of diffuse large B-cellnon Hodgkin’s lymphoma diagnosed on lymph node biopsy presenting for the first time at OncologyDepartment Combined Military Hospital Rawalpindi were included. They were admitted in the wardand evaluated with history, physical examination and staging investigations. Patients were then plannedfor first cycle of chemotherapy comprising cyclophosphamide, doxorubicin, and vincristine withprednisolon. After the first cycle of chemotherapy they were monitored for expected neutropenia in theward. The neutrophil counts were repeated on days 7 and 10 following chemotherapy. Neutropenia wasgraded as defined in the operational definition and all the data was entered on a specially designed datacard. Results: As much as 3.3% of patients suffered from grade IV neutropenia (absolute neutrophilcount of <0.5×109/L), 3.3% had grade III neutropenia (absolute neutrophil count of 0.5×109/L–0.9×109/L), 6.6% had Grade II neutropenia (absolute neutrophil count 1.0×109/L–1.4×109/L and 10%had Grade I neutropenia (absolute neutrophil count 1.5×109/L–1.9×109/L. Conclusion: Overall 23.2%suffered from neutropenia of all grades post 1st cycle of chemotherapy comprising cyclophosphamide,doxorubicin, vincristine with prednisolon in diffuse large B-cell non Hodgkin’s lymphoma. Furtherstudies are required to find the risk factors to predict this complication in our population.Keywords: Non Hodgkin’s lymphoma, CHOP chemotherapy, NeutropeniaReferences
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