Credit: Volker Brinkmann
New research suggests that older non-Hodgkin lymphoma patients are more likely than their younger counterparts to receive prophylaxis for neutropenia, but the older patients still have a higher incidence of severe neutropenia.
Most of the patients studied had received granulocyte colony-stimulating factor (G-CSF) as neutropenia prophylaxis, but more than half of patients in each age group developed grade 3/4 neutropenia.
And although patients aged 65 and older were more likely to receive G-CSF, they had a higher incidence of grade 3/4 neutropenia than patients who were younger than 65.
Lee S. Schwartzberg, MD, of The West Clinic in Memphis, Tennessee, and his colleagues reported these findings in Supportive Care in Cancer.
The researchers conducted a review of 1579 patients with non-Hodgkin lymphoma. Nearly 46% of patients were 65 years of age or older, and 54.1% were younger than 65.
Most patients had received treatment with R-CHOP every 3 weeks. And the dose levels were about the same in both groups of patients. The mean relative dose intensity was 80.4% among younger patients and 73.9% among the older patients.
The incidence of treatment delays was similar between the 2 groups—24.6% among the older patients and 26.5% among the younger patients.
But older patients were more likely to experience dose reductions—24.9% compared to 9.6% of younger patients.
A majority of all patients—86.9%—received G-CSF, but older patients were more likely to receive it upfront.
Among the older patients, 80.1% received G-CSF as primary prophylaxis, 11.6% received it as secondary prophylaxis, and 8.3% received it as treatment.
Among the younger patients, 71.9% received G-CSF as primary prophylaxis, 17.4% received it as secondary prophylaxis, and 10.7% received it as treatment.
The incidence of grade 3/4 neutropenia was 52.3% for the younger patients and 63.2% for the older patients.
