analysis of the risk factors for the neutropenic fever in the high risk nhl patients for developing febrile neutropenia who received 3-weekly chop-like chemotherapy with primary g-csf prophylaxis; prospective multicenter observation study

Conditions: Non-Hodgkin's Lymphoma

Summary: the domestic standards of g-csf permit the use of the g-csf only when the anc(absolute neutrophil count) drops to 1,000/ul or below. therefore it is impossible to inject the g-csf in order to prevent neutropenia. however, 'the 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline(j clinoncol 2006; 24:3187-3205)' and the 'nccn guideline' have revealed that as a precaution, it is appropriate to inject the g-csf to the non-hodgkin's lymphoma patients with high-risk factors under the anticancer treatment of chop-21 rituximab before the number of neutrophils decreases. thus, it is intended to analyze the risk factors of febrile neutropenia in a high-risk group of non-hodgkin's lymphoma patients with a neutropenic fever who receive the chop-like regimen and primary g-csf prophylactic therapy every three weeks. (the definition of neutropenic fever is a fever over 38.3 degrees c or continuous fever lasting longer than 1 hour over 38 degrees c with the number of neutrophil ≤ 500/ul or neutrophil ≤ 1,000/ul in case of expected decline to ≤ 500/ul within 48 hours.)


Eligibility criteria:
inclusion criteria: * histologically diagnosed non-hodgkin's lymphoma patients treated by chop-regimen or r (rituximab)-chop regimen at 21±5 days interval * age \>= 20 years old * the patients with at least one of the following risk factor of neutropenic fever at initiation of anti-cancer treatment 1. age \>= 65 years old 2. progressed stage of disease (ann arbor stage iii) 3. history of previous anti-cancer treatment 4. history of previous radiotherapy (including bone region includes bone marrow) 5. bone marrow involvement 6. comorbid neutropenia (neutrophils \< 1,500/ul ) before the initiation of anti-cancer treatment 7. comorbid anemia (hemoglobin \< 12.0 g/dl ) before the initiation of anti-cancer treatment 8. evidence of activated inflammation 9. existence of open wound 10. poor health state (ecog 2) 11. poor nutritional state (serum albumin \< 3.5 g/dl) 12. kidney disease or renal insufficiency 13. liver disease (chronic hepatitis or cirrhosis) or hepatic insufficiency 14. chronic obstructive pulmonary disease (copd) 15. cardiovascular disease 16. diabetes mellitus * increased cardiac output by 50% above the baseline without clinically significant abnormal findings on muga or echocardiography * life expectancy \>=6 months * amenorrhea less than 1 year (less than 1 year after menopause) or premenopausal female with negative response to serum or urine pregnancy test before initiation of the treatment * voluntary participants with written consent agreement for this study exclusion criteria: * the patients treated by other anti-cancer treatment except chop regimen or r (rituximab)-chop regimen at 21 days interval * pregnant or breast feeding woman, fertile woman without appropriate contraception * patients with hypersensitivity against study drugs * patients treated by other study medication or co-treatment with anticancer chemotherapy, hormone therapy, and immunotherapy