Asian Oncol Nurs.  2022 Sep;22(3):153-162. 10.5388/aon.2022.22.3.153.

Factors Associated with Chemotherapy-induced Neutropenia in Diffuse Large B-cell Lymphoma Patients Undergoing Combination Chemotherapy: A Case-Control Study

  • 1Nurse, Department of Nursing, Chonnam National University Hwasun Hospital, Hwasun, Korea
  • 2Professor, College of Nursing, Chonnam National University, Gwangju, Korea


This study aimed to identify the factors associated with chemotherapy-induced neutropenia (CIN) in diffuse large B-cell lymphoma (DLBCL) patients undergoing combination chemotherapy.
A total of 111 patients with DLBCL participated in this study at C University Hospital. The CIN group consisted of patients with an absolute neutrophil count (ANC) lower than 1,000 cells/μL. Clinical factors, the level of depression, and the level of healthy lifestyle were measured on the chemotherapy administration day, and the ANC was measured on the next follow-up day.
Binary logistic regression analysis showed that the factors associated with CIN in DLBCL were the presence of B symptoms at diagnosis (β=4.69) and low-risk CIN regimen (β=0.10) among clinical factors, and the level of healthy lifestyle (β=0.17).
Oncology nurses have to focus on the patients vulnerable to CIN having B symptoms at diagnosis, receiving a low-risk CIN regimen, and showing non-adherence to healthy lifestyle practice. Administration of granulocyte colony-stimulating factor can be considered for the patients receiving low-risk CIN regimen to reduce CIN. Education programs including healthy lifestyle practice to improve the immune system should be applied to the DLBCL patients.


Diffuse large B-cell lymphoma; Chemotherapy-induced febrile neutropenia; Precipitating factors
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