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Abstract
We conducted a cohort study to examine the association between a wide variety of chronic comorbidities and risk of febrile neutropenia (FN) in patients with non-Hodgkin lymphoma (NHL) from 2000 to 2009 treated with chemotherapy at Kaiser Permanente Southern California. History of comorbidities and FN events were identified using electronic medical records. Cox model adjusting for propensity score was used to determine the association between a comorbid condition and FN. Models that additionally adjusted for cancer stage, baseline absolute neutrophil count, chemotherapy regimen and dose reduction were also evaluated. A total of 2480 patients with NHL were included, and 60% received CHOP/R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone, with or without rituximab). In total, 236 (9.5%) patients developed FN in the first chemotherapy cycle. Anemia (adjusted hazard ratio [HR] = 1.6, 95% confidence interval [1.2–2.2]), HIV infection (HR = 3.8 [2.0–6.7]) and rheumatoid diseases (HR = 2.4 [1.3–4.0]) were associated with significantly increased risk of FN. These results provide evidence that chronic comorbidity increases the risk of FN.
Acknowledgements
C. Chao and S.-J. Yang received research funding from Amgen Inc. for this study.
Potential conflict of interest
Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.
Supplementary material available online
Supplementary Table I showing methods for identifying comorbid conditions
Notice of Correction
The version of this article published online ahead of print on the 2nd May 2014 contained an error on page 6. In Table II, the figures in the ‘Other autoimmune conditions, (Yes section)’ had errors. The error has been corrected for this version.