Predictive Biomarkers in Late Onset Neutropenia Associated with Rituximab

Abstract

Objectives: The aim of this study is to determine the biomarkers in LON (Late Onset Neutropenia) associated withrituximab using in lymphoproliferative diseases (LPDs).Methods: : In this retrospective study 22 cases with LPD treated by rituximab containing regimen and followed at leastone year in our center were evaluated for LON.Results: Grade I, II and IV neutropenia were detected in five, five and one cases, respectively. Lowest neutrophil/lymphocyte ratio (NLR) was 1.2 and 1.7 in cases with and without LON, respectively. Neutropenia developed in 8 of 15 caseswith Diffuse large B cell lymphoma (DLBCL), 2 of 2 cases with Follicular Lymphoma (FL) and one case of Small lymphocytic lymphoma (SLL). According to prophylactic Granulocyte colony-stimulating factor (G-CSF) using, neutropenia wasdetected in all cases given prophylaxis while 6 of 17 cases without prophylaxis. Mean rituximab dose was 4870 mg incases developing neutropenia while it was 4162 mg in cases without neutropenia.Conclusion: Lower NLR at the end of treatment cycle, G-CSF using with prophylaxis aim, extranodal involvement andmore than 4 gr rituximab using were found as the predictive factors for LON associated with rituximab.