Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/20112
Title
Differential Impact of Relative Dose-Intensity Reductions in Diffuse Large B-Cell Lymphoma Treated with R-CHOP21 or R-CHOP14
Author(s)
Gutierrez, Antonio | Bento, Leyre | Maria Bautista-Gili, Antonia | Garcia, Francesc | Martinez-Serra, Jordi | Sanchez, Blanca | Martorell, Clara | Gines, Jordi | Garcia, Lucia | Gimeno, Eva | Ferraro, Mariana | del Campo Garcia, Raquel | Bargay Lleonart, Joan | Perez, Albert | Vercher, Javier | Scaff, Miguel | Pacheco, Ana | Ballester Ruiz, Maria del Carmen | Garcia, Florencia | Ramos-Asensio, Rafael | Salar, Antonio | Besalduch Vidal, Juan
Date issued
2015-04-24
Citation
Gutierrez A, Bento L, Bautista-Gili AM, Garcia F, Martinez Serra JJ, Sanchez B, et al. Differential Impact of Relative Dose-Intensity Reductions in Diffuse Large B-Cell Lymphoma Treated with R-CHOP21 or R-CHOP14. PLoS One. 2015 Apr 24;10(4):e0123978.
Language
Inglés
Document type
research article
Abstract
DLBCL is an aggressive lymphoma treated with R-CHOP. Recently, attempts have been made to improve the outcome by increasing both dose-density and intensity but there have been no benefits in terms of survival. When treating malignancies RDI is important to consider but there is little published information on DLBCL. The purpose of this study was to analyze the differential prognostic impact of RDI in two cohorts of DLBCL patients treated with R-CHOP21 or R-CHOP14. From January 2001 to August 2013 we included DLBCL patients homogenously treated with R-CHOP21 or R-CHOP14, with or without radiotherapy, at University Hospital Son Espases, Hospital Son Llatzer of Palma and Hospital del Mar of Barcelona (N = 157). In order to avoid selection bias the patients were retrospectively identified from the Pathology Department and Pharmacy registries. Median follow-up was 68 months. There was no difference in the response or survival between the two cohorts. In the R-CHOP21 group, both a reduction higher than 15% in RDI (RR 7.41) and R-IPI (RR 2.99) were independently associated with OS. However, a reduction higher than 15% in RDI (RR 4.41) was only noted for PFS. In the R-CHOP14 group, NCCN-IPI (RR 7.09) and B-symptoms (RR 5.37) for OS; AA stage III-IV (RR 6.26) and bulky disease (RR 4.05) for PFS. There was a trend towards a higher rate of RDI reduction observed in the R-CHOP14 group but it only made an impact in the R-CHOP21 group. We conclude that R-CHOP21 and R-CHOP14 are equivalent regimens in terms of response and survival, but only if RDI reductions are avoided. For patients receiving R-CHOP21 we recommend using clinical and support measures in order to avoid RDI reductions.
MESH
Aged, 80 and over | Aged | Doxorubicin | Young Adult | Adult | Cyclophosphamide | Humans | Adolescent | Antineoplastic Combined Chemotherapy Protocols | Combined Modality Therapy | Middle Aged | Neoplasm Grading | Prognosis | Male | Female | Treatment Outcome | Vincristine | Lymphoma, Large B-Cell, Diffuse | Prednisone | Antibodies, Monoclonal, Murine-Derived
DECS
Resultado del Tratamiento | Vincristina | Linfoma de Células B Grandes Difuso | Femenino | Clasificación del Tumor | Terapia Combinada | Adolescente | Masculino | Anticuerpos Monoclonales de Origen Murino | Ciclofosfamida | Humanos | Persona de Mediana Edad | Adulto Joven | Protocolos de Quimioterapia Combinada Antineoplásica | Pronóstico | Anciano | Anciano de 80 o más Años | Doxorrubicina | Adulto | Prednisona
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