ISSN: 0034-8376
eISSN: 2564-8896

Late-Onset Hematological Toxicity (LOHT) in Patients with B-Cell Lymphomas: A Survey in 758 Cases

Adriana Palacios-Campos, Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, México
Alfonso Dueñas-González, Departments of Clinical Research and Medical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
Olga Gutiérrez-Hernández, Pharmacogenetics Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
Myrna Candelaria-Hernández, Pharmacogenetics Laboratory; Hematology Department, Instituto Nacional de Cancerología, Mexico City, Mexico

Background: The increasing survival of patients with non-Hodgkin lymphoma has allowed the diagnosis of long-term complications, including late-onset hematological toxicity (LOHT), transitory cytopenias, or therapy-related myeloid neoplasm (t-MDS/t-AML). Objective: The objective of the study was to determine the frequency and clinical evolution of LOHT in patients with lymphoproliferative malignancies. Materials and Methods: Two cohorts of patients B-cell lymphomas were reviewed. Patients who achieved full hematologic recovery at the end of treatment, and thereafter developed any degree of cytopenia were included in the study. Clinical and biochemical parameters were compared between patients with and without cytopenias with X2 test. Bi- and multivariate analyses were performed to evaluate factors associated with the development of late-onset cytopenias. Results: Of 758 patients enrolled, 19 developed cytopenias (2.5%). Transitory cytopenia was documented in 6 cases, 3 developed ICUS, 8 t-MDS, and 2 t-AML. In patients with FL, only hemoglobin < 12 g/dL (p = 0.032) and >6 nodal areas (p = 0.037) at diagnosis were factors statistically significant for the development of cytopenia. During cytopenias, 55% of patients died. Conclusions: LOHT constitutes a cause of morbidity and mortality in 2.5% of lymphoma patients treated with different therapy regimens.

Keywords: Transitory cytopenias. Therapy-related myeloid neoplasm (t-MDS/t-AML). B-cell lymphomas. Late-onset toxicity.