Outcomes of Early and Late Administration G-CSF for Primary Prophylaxis in Non-Hodgkin's Lymphoma Patients

This study aims to analyze the impact of the timing of granulocyte colony-stimulating factor (G-CSF) administration on the prevention of febrile neutropenia (FN) in non-Hodgkin's lymphoma patients undergoing standard chemotherapy. G-CSF is a growth factor that stimulates the production of white blood cell in order to fighting infection. When non-Hodgkin's lymphoma patients receive chemotherapy for eradicating cancer cells. They also have collateral damage those white blood cells and other hematopoietic cell lines.

All patients received standard chemotherapy regimens once every four weeks. The study will compare the efficacy of early G-CSF administration, or late administration, after each course of chemotherapy.

The primary endpoint is the incidence of FN in each chemotherapy course. At the end of each chemotherapy course, patients received either early G-CSF (within 72 hours) or late G-CSF (after 72 hours). All patients will be followed up to monitor for FN events.

Secondary endpoints include the incidence of myelosuppression and quality of life, assessed during outpatient and emergency department visits.

Inclusion criteria

• Aged 18 years or old
• Confirmed lymphoma undergoing standard chemotherapy
• Signed an approval informed consent
• Has a good understanding of Thai
• Available for follow-up after chemotherapy

Exclusion criteria

• Pregnancy or lactation
• Serious concomitant diseases and discontinuous treatment such as cardiovascular, liver, or kidney diseases
• Contraindication to chemotherapy or G-CSF administration
• Antibiotic use within 1 week prior to enrollment