Infection risk and cancer chemotherapy: the impact of the chemotherapeutic regimen in patients with lymphoma and solid tissue malignancies

Modern chemotherapy for lymphoma and solid tissue malignancy is most frequently administered in a cyclical fashion on an outpatient basis over many months. During this time patients have a significant risk of developing severe neutropenia due to the myelotoxic effects of the treatment regimens; this increases the risk of potentially life-threatening infection. The risk of grade IV neutropenia (<0.5 x 10(9)/L) ranges from approximately 20% to >70% depending upon the cytotoxic potential of the regimen. The risks of infection associated with severe neutropenia range from approximately 10-20% to >50%. Haematopoietic growth factors have had only minimal impact on these risks and on the natural history of febrile neutropenic events that occur during the course of cancer chemotherapy.