OBJECTIVES:  Cost of chemotherapy-induced febrile neutropenia (FN) in the United States has been reported to be substantial.  Little is known about the cost of FN in other countries or about costs of follow-on care and subsequent FN events. METHODS: Data were obtained from an observational study of supportive care in patients with non-Hodgkin’s lymphoma (NHL) receiving CHOP-14 or CHOP-21 chemotherapy (±rituximab) predominantly across Europe.  FN was defined as single oral temperature of ≥38.3⁰C or temperature of ≥38.0⁰C for ≥1 hour, and neutrophil count of <0.5x109/L or <1.0x109/L and predicted to fall below 0.5x109/L.  Patients developing FN in a given cycle (“FN patients”), starting with the first cycle, were matched (1:1, without replacement) on age, tumor stage, chemotherapy, and other factors to those not developing FN in that cycle (“comparison patients”), irrespective of FN experience in subsequent cycles.  FN-related healthcare utilization and costs (estimated from UK National Health Service perspective [2010]) were tallied for patients from the match cycle through the last chemotherapy cycle (“follow-up”). RESULTS:  Eighteen percent of patients (331/1829) in the observational study experienced a total of 479 FN events, the majority (77%) of which required inpatient care.  A total of 295 FN patients were matched to comparison patients for these analyses; baseline characteristics were similar between groups.  During follow-up, FN patients averaged 1.44 (95%CI 1.34-1.56) FN events and comparison patients averaged 0.15 (0.10-0.21) FN events, and corresponding mean number of FN-related hospital days was 6.21 (5.28-7.17) and 0.63 (0.30-1.02).  Mean total cost was £5744 (£4893-£6664) higher for FN patients than comparison patients, with 71% of the difference attributable to care in the index cycle (£4051 [£3633-£4485]) and 29% attributable to care in post-index cycles (£1693 [£917-£2447]). CONCLUSIONS: Cost of chemotherapy-induced FN among NHL patients in European clinical practice is substantial, with a sizable percentage attributable to follow-on care and subsequent FN events.