A retrospective evaluation of febrile neutropenia episodes in patients with non-hodgkin lymphoma

Objective The aim of this study was to retrospectively evaluate the frequency, clinical characteristics, association with lymphoma subtypes, and impact on mortality of febrile neutropenia episodes in patients diagnosed with Non-Hodgkin Lymphoma (NHL) who received cytotoxic chemotherapy. Materials and Methods This retrospective study included 68 patients with Non-Hodgkin Lymphoma who developed febrile neutropenia and were followed at the Hematology Clinic of Van Yüzüncü Yıl University Dursun Odabaş Medical Center between January 2014 and December 2024. Demographic characteristics, lymphoma subtypes, number and duration of febrile neutropenia episodes, remission status at the time of the episode, and mortality data were obtained from patient records. Statistical analyses were performed using SPSS version 28.0, and a p value <0.05 was considered statistically significant. Results Of the 68 patients included in the study, 41 (60.3%) were male and 27 (39.7%) were female, with a mean age of 55.59±15.67 years, and no significant age difference was observed between sexes (p>0.05). The mean number of febrile neutropenia episodes was 1.68±0.78 for the entire cohort; it was 1.49±0.59 in males and 1.96±0.94 in females, with no statistically significant association between sex and episode frequency (p>0.05). The mean duration of febrile neutropenia was 9.12±6.06 days, ranging from 3 to 36 days. Regarding lymphoma subtypes, 50% of the patients were diagnosed with diffuse large B-cell lymphoma (DLBCL), followed by T-cell lymphoma (13.2%), B-cell lymphoma (13.2%), and Burkitt lymphoma (10.3%). Febrile neutropenia episodes occurred during remission in 55.8% of cases and outside remission in 44.2%; episodes predominantly developed during remission in patients with DLBCL and B-cell lymphoma, whereas they occurred more frequently outside remission in patients with T-cell and Burkitt lymphoma. Mortality was observed in 13 patients (19%) during febrile neutropenia episodes. The mean duration of febrile neutropenia was significantly shorter in survivors (8.36±5.075 days) compared with patients who died (12.31±8.693 days) (p<0.05). Conclusion Febrile neutropenia remains a significant clinical problem associated with substantial mortality in patients with Non-Hodgkin Lymphoma. Lymphoma subtype and remission status play an important role in the clinical course and outcomes of febrile neutropenia episodes. Early diagnosis, appropriate risk stratification, and timely therapeutic interventions are crucial for reducing febrile neutropenia–related morbidity and mortality. Keywords: Non-Hodgkin lymphoma, febrile neutropenia Advisor: Prof. Dr. Ramazan ESEN