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William G. Wierda, Jennifer Brown, Jeremy S. Abramson, Farrukh Awan, Syed F. Bilgrami, Greg Bociek, Danielle Brander, Asher A. Chanan-Khan, Steve E. Coutre, Randall S. Davis, Herbert Eradat, Christopher D. Fletcher, Sameh Gaballa, Armin Ghobadi, Muhammad Saad Hamid, Francisco Hernandez-Ilizaliturri, Brian Hill, Paul Kaesberg, Manali Kamdar, Lawrence D. Kaplan, Nadia Khan, Thomas J. Kipps, Shuo Ma, Anthony Mato, Claudio Mosse, Stephen Schuster, Tanya Siddiqi, Deborah M. Stephens, Chaitra Ujjani, Nina Wagner-Johnston, Jennifer A. Woyach, J. Christine Ye, Mary A. Dwyer, and Hema Sundar

, opportunistic infections, and febrile neutropenia. NCCN Recommendations Preferred Regimens Acalabrutinib, ibrutinib, and VenR are included with a category 1 recommendation, 20 – 22 , 36 zanubrutinib is included with a category 2A recommendation, 31 and

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NCCN Guidelines® Insights: B-Cell Lymphomas, Version 5.2021

Featured Updates to the NCCN Guidelines

Andrew D. Zelenetz, Leo I. Gordon, Julie E. Chang, Beth Christian, Jeremy S. Abramson, Ranjana H. Advani, Nancy L. Bartlett, L. Elizabeth Budde, Paolo F. Caimi, Sven De Vos, Bhagirathbhai Dholaria, Bita Fakhri, Luis E. Fayad, Martha J. Glenn, Thomas M. Habermann, Francisco Hernandez-Ilizaliturri, Eric Hsi, Boyu Hu, Mark S. Kaminski, Christopher R. Kelsey, Nadia Khan, Susan Krivacic, Ann S. LaCasce, Megan Lim, Mayur Narkhede, Rachel Rabinovitch, Praveen Ramakrishnan, Erin Reid, Kenneth B. Roberts, Hayder Saeed, Stephen D. Smith, Jakub Svoboda, Lode J. Swinnen, Joseph Tuscano, Julie M. Vose, Mary A. Dwyer, and Hema Sundar

with DLBCL refractory to first-line treatment were excluded from this study. Neutropenia (48%), thrombocytopenia (17%), and febrile neutropenia (12%) were the most common grade ≥3 hematologic toxicities. Most nonhematologic adverse events were grade 1

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Paul D. Harker-Murray, Lauren Pommert, and Matthew J. Barth

-EPOCH-R at 24 academic centers, 3-year EFS was 86% (95% CI, 80.3%–91.5%). 27 Although pediatric EFS rates are less than those seen in adults, the DA-EPOCH-R regimen (without radiation) has fewer acute toxicities, including less stomatitis, enteritis, febrile

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Patrick A. Brown, Bijal Shah, Amir Fathi, Matthew Wieduwilt, Anjali Advani, Patricia Aoun, Stefan K. Barta, Michael W. Boyer, Teresa Bryan, Patrick W. Burke, Ryan Cassaday, Peter F. Coccia, Steven E. Coutre, Lloyd E. Damon, Daniel J. DeAngelo, Olga Frankfurt, John P. Greer, Hagop M. Kantarjian, Rebecca B. Klisovic, Gary Kupfer, Mark Litzow, Arthur Liu, Ryan Mattison, Jae Park, Jeffrey Rubnitz, Ayman Saad, Geoffrey L. Uy, Eunice S. Wang, Kristina M. Gregory, and Ndiya Ogba

years; range, 1–20 years), the response rate (CR + CRp) was 20%. 77 Single-agent clofarabine in this setting was associated with severe liver toxicities (generally reversible) and frequent febrile episodes, including grade 3 or 4 infections and febrile

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Katy Winckworth-Prejsnar, Elizabeth A. Nardi, Lisa Korin Lentz, Jeffrey A. Crawford, C. Lyn Fitzgerald, and Robert W. Carlson

-CSF). It is approved for all indications of filgrastim to treat patients with (1) nonmyeloid malignancy receiving myelosuppressive chemotherapy with an intermediate- or high-risk of febrile neutropenia; (2) acute myeloid leukemia receiving induction or

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Andrew D. Zelenetz, Leo I. Gordon, William G. Wierda, Jeremy S. Abramson, Ranjana H. Advani, C. Babis Andreadis, Nancy Bartlett, John C. Byrd, Luis E. Fayad, Richard I. Fisher, Martha J. Glenn, Thomas M. Habermann, Nancy Lee Harris, Francisco Hernandez-Ilizaliturri, Richard T. Hoppe, Steven M. Horwitz, Mark S. Kaminski, Christopher R. Kelsey, Youn H. Kim, Susan Krivacic, Ann S. LaCasce, Matthew Lunning, Auayporn Nademanee, Pierluigi Porcu, Oliver Press, Rachel Rabinovitch, Nishitha Reddy, Erin Reid, Kenneth Roberts, Ayman A. Saad, Lubomir Sokol, Lode J. Swinnen, Julie M. Vose, Joachim Yahalom, Nadeem Zafar, Mary Dwyer, and Hema Sundar

the subgroup with non-GCB phenotype. Febrile neutropenia occurred in 36% (grade 4 in 7%) and no significant grade 4 non-hematologic toxicities were seen. The most common grade 3 non-hematologic toxicities included neuropathies (25%), fatigue (16%), and

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Apar Kishor P. Ganti, Billy W. Loo Jr., Michael Bassetti, Collin Blakely, Anne Chiang, Thomas A. D'Amico, Christopher D'Avella, Afshin Dowlati, Robert J. Downey, Martin Edelman, Charles Florsheim, Kathryn A. Gold, Jonathan W. Goldman, John C. Grecula, Christine Hann, Wade Iams, Puneeth Iyengar, Karen Kelly, Maya Khalil, Marianna Koczywas, Robert E. Merritt, Nisha Mohindra, Julian Molina, Cesar Moran, Saraswati Pokharel, Sonam Puri, Angel Qin, Chad Rusthoven, Jacob Sands, Rafael Santana-Davila, Michael Shafique, Saiama N. Waqar, Kristina M. Gregory, and Miranda Hughes

Currently available cytokines (eg, granulocyte-macrophage colony-stimulating factor [GM-CSF], G-CSF) can ameliorate chemotherapy-induced myelosuppression and reduce the incidence of febrile neutropenia, but cumulative thrombocytopenia remains dose

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Joseph C. Alvarnas, Patrick A. Brown, Patricia Aoun, Karen Kuhn Ballen, Stefan K. Barta, Uma Borate, Michael W. Boyer, Patrick W. Burke, Ryan Cassaday, Januario E. Castro, Peter F. Coccia, Steven E. Coutre, Lloyd E. Damon, Daniel J. DeAngelo, Dan Douer, Olga Frankfurt, John P. Greer, Robert A. Johnson, Hagop M. Kantarjian, Rebecca B. Klisovic, Gary Kupfer, Mark Litzow, Arthur Liu, Arati V. Rao, Bijal Shah, Geoffrey L. Uy, Eunice S. Wang, Andrew D. Zelenetz, Kristina Gregory, and Courtney Smith

infections and febrile neutropenia. 106 , 107 In a small phase II study evaluating the combination of clofarabine with cyclophosphamide and etoposide in pediatric patients with refractory or multiple relapsed ALL (n = 25; median age, 12.5 years), the

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Lindsey Robert Baden, Sankar Swaminathan, Michael Angarone, Gayle Blouin, Bernard C. Camins, Corey Casper, Brenda Cooper, Erik R. Dubberke, Ashley Morris Engemann, Alison G. Freifeld, John N. Greene, James I. Ito, Daniel R. Kaul, Mark E. Lustberg, Jose G. Montoya, Ken Rolston, Gowri Satyanarayana, Brahm Segal, Susan K. Seo, Shmuel Shoham, Randy Taplitz, Jeffrey Topal, John W. Wilson, Karin G. Hoffmann, and Courtney Smith

fever in patients with cancer and treatment-induced neutropenia . N Engl J Med 1993 ; 328 : 1323 – 1332 . 8. Rolston KV Rubenstein EB Freifeld A . Early empiric antibiotic therapy for febrile neutropenia patients at low risk . Infect Dis

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David S. Ettinger, Wallace Akerley, Hossein Borghaei, Andrew C. Chang, Richard T. Cheney, Lucian R. Chirieac, Thomas A. D’Amico, Todd L. Demmy, Apar Kishor P. Ganti, Ramaswamy Govindan, Frederic W. Grannis Jr, Leora Horn, Thierry M. Jahan, Mohammad Jahanzeb, Anne Kessinger, Ritsuko Komaki, Feng-Ming (Spring) Kong, Mark G. Kris, Lee M. Krug, Inga T. Lennes, Billy W. Loo Jr, Renato Martins, Janis O’Malley, Raymond U. Osarogiagbon, Gregory A. Otterson, Jyoti D. Patel, Mary C. Pinder-Schenck, Katherine M. Pisters, Karen Reckamp, Gregory J. Riely, Eric Rohren, Scott J. Swanson, Douglas E. Wood, Stephen C. Yang, Miranda Hughes, and Kristina M. Gregory

cell histology had improved survival with cisplatin/gemcitabine (10.8 vs. 9.4 months). The cisplatin/pemetrexed regimen had significantly lower rates of grade 3 or 4 neutropenia, anemia, and thrombocytopenia ( P ≤ .001); febrile neutropenia ( P = .002