[Clinical characteristics of acute thrombocytopenia in newly diagnosed follicular lymphoma patients receiving obinutuzumab chemotherapy].
- 1Department of Hematology, Suqian Hospital of Jiangsu Province People's Hospital, The First People's Hospital of Suqian City, Suqian 223800, China.
- 2Department of Hematology, Lymphoma Center, Nanjing Medical University Affiliated First Hospital, Jiangsu Provincial People's Hospital, Nanjing 210029, China.
Abstract
Objective: To evaluate the efficacy and safety of first-line immunochemotherapy with obinutuzumab in patients with follicular lymphoma (FL), with a particular focus on the clinical characteristics and potential risk factors of obinutuzumab-induced acute thrombocytopenia (OIAT) . Methods: The present retrospective study included 167 newly diagnosed FL patients receiving G-CHOP or GB regimens at Jiangsu Provincial People's Hospital between January 2021 and December 2024. The patients' baseline clinical characteristics and serial platelet (PLT) count were collected. In patients with OIAT, the nadir PLT count and recovery time were recorded. Logistic regression analysis was performed to identify the risk factors for OIAT. Results: Among the 167 patients, 65 (38.9%) developed OIAT, including 18 (27.7%) patients with grade 3-4 thrombocytopenia. The median time to OIAT onset was 1.0 (1.0, 2.0) days after the first administration, and the median recovery time was 8.0 (6.0, 16.0) days. Compared to patients without OIAT (102/167, 61.1%), those with OIAT had lower baseline neutrophil percentage [median: 3.4 (2.5, 4.9) % vs 4.3 (3.1, 6.6) %, P=0.005], lower D-dimer levels [0.2 (0.1, 0.7) mg/L vs 0.6 (0.3, 1.3) mg/L, P=0.001], higher IL-10 levels [8.0 (3.7, 32.0) ng/L vs 4.6 (2.4, 7.9) ng/L, P=0.008], higher β₂-microglobulin levels [2.7 (1.8, 3.9) mg/L vs 2.2 (1.7, 3.0) mg/L, P=0.024], lower CD4(+) T cell counts [ (32.4 ± 17.6) cells/μl, vs (37.4 ± 11.8) cells/μl, P=0.043], and lower IgA levels [1.2 (1.0, 2.1) g/L vs 1.6 (1.2, 2.2) g/L, P=0.045]. Multivariate analysis showed that extranodal involvement (OR=3.395, 95% CI: 1.229-9.378, P=0.018), FLIPI-2 score >3 (OR=3.622, 95% CI: 1.192-10.973, P=0.023), and baseline PLT count of <150×10(9)/L (OR=3.216, 95% CI: 1.122-9.215, P=0.030) were the independent risk factors for OIAT. In patients with grade 1-2 and 3-4 OIAT, the use of thrombopoietic therapy had no significant effect on prolonged PLT recovery time [grade 1-2: median: 7.1 (5.0, 12.5) days vs 7.4 (5.2, 13.0) days, P=0.338; grades 3-4: (21.0 ± 14.4) days vs (15.5 ± 9.9) days, P=0.420]. However, patients with grade 3-4 OIAT had significantly prolonged PLT recovery time [median: 16.0 (8.0, 18.5) days vs 7.0 (5.0, 12.8) days, P=0.010] and were more likely to experience non-hematologic adverse events[incidence rate: 72.2% (13/18) vs 40.4% (19/47), P<0.001]. Conclusion: OIAT commonly occurs after the initial drug administration, with the risk significantly increased in patients with high baseline tumor burden and impaired immune status. Grade 1-2 thrombocytopenia may be observed during follow-up, whereas Grade 3-4 cases require close monitoring and active intervention. Identifying high-risk patients and implementing stratified management strategies can help optimize treatment safety.
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BibTeX
@article{zhou2026clinical,
title = {{[Clinical characteristics of acute thrombocytopenia in newly diagnosed follicular lymphoma patients receiving obinutuzumab chemotherapy].}},
author = {J X Zhou and L Gao and Y Xia and S C Qin and H N Tang and Y L Kong and L Fan and J Y Li and H Y Zhu},
journal = {Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi},
year = {2026},
month = aug,
doi = {10.3760/cma.j.cn121090-20260225-00108},
url = {https://europepmc.org/article/MED/42851176},
note = {CC BY},
}
RIS
TY - JOUR
TI - [Clinical characteristics of acute thrombocytopenia in newly diagnosed follicular lymphoma patients receiving obinutuzumab chemotherapy].
AU - J X Zhou
AU - L Gao
AU - Y Xia
AU - S C Qin
AU - H N Tang
AU - Y L Kong
AU - L Fan
AU - J Y Li
AU - H Y Zhu
PY - 2026
DA - 2026/08/01
JO - Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi
DO - 10.3760/cma.j.cn121090-20260225-00108
UR - https://europepmc.org/article/MED/42851176
AB - Objective: To evaluate the efficacy and safety of first-line immunochemotherapy with obinutuzumab in patients with follicular lymphoma (FL), with a particular focus on the clinical characteristics and potential risk factors of obinutuzumab-induced acute thrombocytopenia (OIAT) . Methods: The present retrospective study included 167 newly diagnosed FL patients receiving G-CHOP or GB regimens at Jiangsu Provincial People's Hospital between January 2021 and December 2024. The patients' baseline clinical characteristics and serial platelet (PLT) count were collected. In patients with OIAT, the nadir PLT count and recovery time were recorded. Logistic regression analysis was performed to identify the risk factors for OIAT. Results: Among the 167 patients, 65 (38.9%) developed OIAT, including 18 (27.7%) patients with grade 3-4 thrombocytopenia. The median time to OIAT onset was 1.0 (1.0, 2.0) days after the first administration, and the median recovery time was 8.0 (6.0, 16.0) days. Compared to patients without OIAT (102/167, 61.1%), those with OIAT had lower baseline neutrophil percentage [median: 3.4 (2.5, 4.9) % vs 4.3 (3.1, 6.6) %, P=0.005], lower D-dimer levels [0.2 (0.1, 0.7) mg/L vs 0.6 (0.3, 1.3) mg/L, P=0.001], higher IL-10 levels [8.0 (3.7, 32.0) ng/L vs 4.6 (2.4, 7.9) ng/L, P=0.008], higher β₂-microglobulin levels [2.7 (1.8, 3.9) mg/L vs 2.2 (1.7, 3.0) mg/L, P=0.024], lower CD4(+) T cell counts [ (32.4 ± 17.6) cells/μl, vs (37.4 ± 11.8) cells/μl, P=0.043], and lower IgA levels [1.2 (1.0, 2.1) g/L vs 1.6 (1.2, 2.2) g/L, P=0.045]. Multivariate analysis showed that extranodal involvement (OR=3.395, 95% CI: 1.229-9.378, P=0.018), FLIPI-2 score >3 (OR=3.622, 95% CI: 1.192-10.973, P=0.023), and baseline PLT count of <150×10(9)/L (OR=3.216, 95% CI: 1.122-9.215, P=0.030) were the independent risk factors for OIAT. In patients with grade 1-2 and 3-4 OIAT, the use of thrombopoietic therapy had no significant effect on prolonged PLT recovery time [grade 1-2: median: 7.1 (5.0, 12.5) days vs 7.4 (5.2, 13.0) days, P=0.338; grades 3-4: (21.0 ± 14.4) days vs (15.5 ± 9.9) days, P=0.420]. However, patients with grade 3-4 OIAT had significantly prolonged PLT recovery time [median: 16.0 (8.0, 18.5) days vs 7.0 (5.0, 12.8) days, P=0.010] and were more likely to experience non-hematologic adverse events[incidence rate: 72.2% (13/18) vs 40.4% (19/47), P<0.001]. Conclusion: OIAT commonly occurs after the initial drug administration, with the risk significantly increased in patients with high baseline tumor burden and impaired immune status. Grade 1-2 thrombocytopenia may be observed during follow-up, whereas Grade 3-4 cases require close monitoring and active intervention. Identifying high-risk patients and implementing stratified management strategies can help optimize treatment safety.
SN - 0253-2727
SN - 2707-9740
ER -