This study aimed to evaluate the prognostic significance of hematological toxicity during cervical cancer treatment. MethodsPatients who were treated with definitive chemoradiation therapy for cervical carcinoma were identified. Toxicities were assessed during weeks 1 to 6 of concurrent external beam radiation therapy and chemotherapy. Outcomes were analyzed using Cox regression analysis. ResultsA total of 121 patients with FIGO stage I-III disease were eligible for analysis. The median age at diagnosis was 45 years (IQR, 40 to 52 years), and the median follow-up time was 34 months (95% CI, 30.8-37.2). All patients experienced hematologic toxicity. The most common toxicities greater than grade 3 were low absolute lymphocyte count (n=115, 95%), low white blood cell count (n=21, 17%), and anemia (n=11, 9%). The most common grade 4 toxicity was lymphopenia, which occurred in 36% of the patients (n=44). Grade 4 lymphopenia was associated with reduced overall survival (HR, 4.5; P=0.005), progression-free survival (HR, 3.4; P=0.001), and local control (HR, 4.1; P=0.047). Grade 3 to 4 anemia was also associated with reduced overall survival (HR, 4.1; P=0.014). After the disease and treatment variables were controlled for, grade 4 lymphopenia remained significantly associated with reduced overall survival (HR, 9.85; P=0.007); this association remained significant only in the women of Hispanic ethnicity. ConclusionSevere lymphopenia was associated with reduced overall survival and progression-free survival among the Hispanic women who underwent definitive chemoradiation therapy for cervical cancer, but not with the outcomes among the non-Hispanic women.