| Abstract: |
Treatment of diffuse large B-cell lymphoma (DLBCL) with CHOP-21 (cyclophosphamide 750 mg/m 2, doxorubicin 50 mg/m 2, vincristine 1.4 mg/m 2, prednisone 100 mg for 5 days every 21 days) results in long-term remission in approximately 45% of patients. Recent phase III trials have demonstrated improved survival by modifying CHOP either through adding rituximab or shortening the time between cycles to 14 days. These studies prompted our institution to treat newly diagnosed patients with DLBCL refusing or not eligible for protocol-based therapy with R-CHOP-14. In this single-institution retrospective analysis, we report our results with this regimen. Forty-nine patients with newly diagnosed DLBCL and ineligible or refusing protocol-based therapy were retrospectively identified. Patients were treated with 6 - 8 cycles of R-CHOP-14 given with filgrastim and prophylactic antibiotics. The main toxicities with R-CHOP-14 were hematological and neurological and were not unexpected. There were no treatment-related deaths. Patients received 90% of planned cytotoxic drug density. The complete remission/complete remission uncertain (CR/CRu) rate was 82.2%. At a median follow-up of 24 months, the event-free survival was 80% and overall survival 90%. These results demonstrate R-CHOP-14 can be given to patients safely and short-term results regarding survival are promising. Whether adding rituximab and increasing dose intensity improves survival over either alone will require randomized studies. © 2005 Taylor & Francis Group Ltd. |
| Keywords: |
adult; cancer survival; clinical article; treatment outcome; middle aged; survival analysis; antibiotic agent; retrospective studies; prednisone; constipation; fatigue; neutropenia; doxorubicin; drug efficacy; drug safety; chemotherapy; rituximab; neurotoxicity; follow-up studies; prospective studies; edema; erythropoietin; anemia; bone marrow suppression; etoposide; blood toxicity; mucosa inflammation; thrombocytopenia; antineoplastic combined chemotherapy protocols; dehydration; peripheral neuropathy; cyclophosphamide; vincristine; clinical protocol; herpes simplex; kidney failure; dose-response relationship, drug; retrospective study; asthenia; febrile neutropenia; drug fatality; b cell lymphoma; lymphoma, b-cell; cancer regression; antibodies, monoclonal; feasibility study; feasibility studies; lymphoma; nausea and vomiting; antivirus agent; large cell lymphoma; recombinant granulocyte colony stimulating factor; drug dose regimen; cotrimoxazole; heart atrium fibrillation; congestive heart failure; atovaquone; fluconazole; bronchitis; upper respiratory tract infection; aggressive; pneumocystosis; lymphoma, large-cell, diffuse; retrospective; dose density; disseminated intravascular clotting
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