Background: Daily CBC (Complete blood count) and CMP (Complete metabolic profile) have been drawn on our patients with high-grade lymphoma admitted for inpatient chemotherapy with R-EPOCH (Rituximab, Prednisone, Vincristine, Cyclophosphamide, Doxorubicin) which is given over 5 days and R-ICE (Rituximab, Ifosfamide, Carboplatin, Etoposide) which is given over 3 day period. We conducted a retrospective study at our center looking to find if daily laboratory, other than day 1 laboratory, will have an impact on decisions regarding 1) change in chemotherapy dose or schedule 2) requirement of Blood products transfusion 3) cost effectiveness.
Methods: We did retrospective review of 101 admissions between 2010-2017. We documented how frequent CBC and CMP were obtained during patient admissions. We documented any change in chemotherapy schedule or dose, or any need for blood product transfusion based on results of laboratory obtained starting day 2 of cycle 2. We excluded day 1 given that its results are required to proceed with chemotherapy. Also we excluded induction cycle 1. We documented cost of laboratory obtained other than day 1.
Results: Daily CBC and CMP did not lead to any significant changes in plan of care of chemotherapy regimen and only lead to blood transfusions in 4.1% of patients on R-EPOCH and 6% of patients on R-ICE regimens. The cost associated with daily CBC and CMP was $1725 for R-EPOCH regimen and $1339 for R-ICE regimen.
Conclusion: We recommend only day 1 CBC/CMP for patients admitted for R-EPOCH and R-ICE chemotherapy starting cycle 2. Daily CBC/CMP didn't lead to any significant changes on the plan of care and added more cost.
No relevant conflicts of interest to declare.
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