Aguiar-Bujanda David, Blanco-Sánchez María Jesús, Hernández-Sosa María, Galván-Ruíz Saray, Hernández-Sarmiento Samuel, Saura-Grau Salvador, Bohn-Sarmiento Uriel
Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain.
Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain.
Clin Lymphoma Myeloma Leuk. 2015 Dec;15(12):761-5. doi: 10.1016/j.clml.2015.07.635. Epub 2015 Aug 6.
Late-onset neutropenia (LON) is a known adverse effect to rituximab therapy. Information about its real incidence and clinical implications comes from case reports and few retrospective studies specifically designed to study LON. However, large prospective studies of LON are lacking in the literature. We aimed to determine the incidence of LON in a group of non-Hodgkin lymphoma patients treated with rituximab and to analyze the clinical course, complications, and risk factors associated with LON.
We retrospectively reviewed 183 patients with a diagnosis of non-Hodgkin lymphoma consecutively treated with rituximab alone or in combination with chemotherapy.
We identified 11 patients with grade 3/4 LON (13 episodes) out of 183 patients (6%). The median time to onset of LON was 75 days, and the median time to recovery from neutropenia was 100 days. The median neutrophil count nadir was 0.55 × 10(9)/L (range, 0.06-0.9 × 10(9)/L). Two patients presented infectious complications, one with fatal outcome.
In our experience, the incidence of recognized LON is low (6%), although its real incidence may be greater because of the asymptomatic course and quick recovery in most cases. Infectious complications are unusual, but life-threatening complications can emerge. A careful evaluation of all cases of LON is warranted.
迟发性中性粒细胞减少症（LON）是利妥昔单抗治疗已知的不良反应。关于其实际发病率和临床意义的信息来自病例报告以及少数专门设计用于研究LON的回顾性研究。然而，文献中缺乏关于LON的大型前瞻性研究。我们旨在确定一组接受利妥昔单抗治疗的非霍奇金淋巴瘤患者中LON的发病率，并分析与LON相关的临床病程、并发症和危险因素。
我们回顾性分析了183例连续接受单独利妥昔单抗或联合化疗治疗的非霍奇金淋巴瘤患者。
我们在183例患者中识别出11例3/4级LON患者（13次发作）（6%）。LON的中位发病时间为75天，从中性粒细胞减少症恢复的中位时间为100天。中性粒细胞计数最低点的中位数为0.55×10⁹/L（范围为0.06 - 0.9×10⁹/L）。2例患者出现感染并发症，其中1例死亡。
根据我们的经验，已确认的LON发病率较低（6%），尽管由于大多数病例病程无症状且恢复快，其实际发病率可能更高。感染并发症不常见，但可能出现危及生命的并发症。对所有LON病例进行仔细评估是必要的。
