A Fondazione Italiana Linfomi cohort study of R-COMP vs R-CHOP in older patients with diffuse large B-cell lymphoma.

Autor:	Arcari A; Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy., Rigacci L; UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma, Italy., Tucci A; Hematology Division, ASST Spedali Civili di Brescia, Brescia, Italy., Puccini B; Lymphoma Unit, Hematology Department, Careggi Hospital and University of Florence, Firenze, Italy., Usai SV; Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy., Cavallo F; Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU 'Città della Salute e della Scienza di Torino,' Torino, Italy., Fabbri A; Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy., Balzarotti M; Department of Medical Oncology and Hematology, Humanitas Clinical Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy., Pelliccia S; Hematology, Department of Clinical and Molecular Medicine, University Hospital Sant'Andrea, Sapienza University of Rome, Rome, Italy., Luminari S; Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.; Department CHIMOMO, University of Modena and Reggio Emilia, Reggio Emilia, Italy., Pennese E; Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy., Zilioli VR; Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy., Mahmoud AM; Hematology, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy., Musuraca G; Hematology, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori 'Dino Amadori,' Meldola, Forlì-Cesena, Italy., Marino D; Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy., Sartori R; Oncohematology Unit, Veneto Institute of Oncology, Veneto Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Castelfranco Veneto, Treviso, Italy., Botto B; Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy., Gini G; Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy., Zanni M; Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy., Hohaus S; University Policlinico Gemelli Foundation Istituto di Ricovero e Cura a Carattere Scientifico, Catholic University of the Sacred Heart, Roma, Italy., Tarantini G; Haematology and Bone Marrow Transplant Unit, Ospedale Monsignor R. Dimiccoli, Barletta, Italy., Flenghi L; Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy., Tani M; Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy., Di Rocco A; Institute of Hematology, Department of Translational and Precision Medicine 'Sapienza,' University of Roma, Roma, Italy., Merli M; Division of Hematology, Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi, University of Insubria, Varese, Italy., Vallisa D; Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy., Pagani C; Hematology Division, ASST Spedali Civili di Brescia, Brescia, Italy., Nassi L; Lymphoma Unit, Hematology Department, Careggi Hospital and University of Florence, Firenze, Italy., Dessì D; Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy., Ferrero S; Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU 'Città della Salute e della Scienza di Torino,' Torino, Italy., Cencini E; Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy., Bernuzzi P; Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy., Mammi C; Gruppo Amici dell'Ematologia GRADE Onlus Foundation, Reggio Emilia, Italy., Marcheselli L; Fondazione Italiana Linfomi Onlus, Modena, Italy., Tabanelli V; Division of Haematopathology, European Institute of Oncology IRCCS, Milan, Italy., Spina M; Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Pordenone, Italy., Merli F; Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 Aug 08; Vol. 7 (15), pp. 4160-4169.
DOI:	10.1182/bloodadvances.2023009839
Abstrakt:	Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the most commonly used regimen for the upfront treatment of diffuse large B-cell lymphoma (DLBCL). However, it is associated with cardiotoxicity, especially in older patients. Substituting doxorubicin with non-PEGylated liposomal doxorubicin (R-COMP) may reduce the risk of cardiac events, but its efficacy has never been demonstrated in prospective trials. We describe the characteristics and outcome of patients with DLBCL aged ≥65 years prospectively enrolled in the Elderly Project by the Fondazione Italiana Linfomi and treated with full doses of R-CHOP or R-COMP per local practice. Starting from 1163 patients, 383 (55%) were treated with R-CHOP and 308 (45%) with R-COMP. Patients treated with R-COMP were older (median age, 76 vs 71 years), less frequently fit at simplified geriatric assessment (61% vs 88%; P < .001), and had a more frequent baseline cardiac disorders (grade >1, 32% vs 8%; P < .001). Three-year progression-free survival (PFS) was similar between R-CHOP and R-COMP (70% and 64%); 3-year overall survival was 77%, and 71% respectively. R-CHOP was associated with better PFS vs R-COMP only in the Elderly Prognostic Index (EPI) low-risk group. The two groups had similar rates of treatment interruptions due to toxicities or of cardiac events (P = 1.00). We suggest R-COMP is a potentially curative treatment for older patients with intermediate- or high-risk EPI, even in the presence of a baseline cardiopathy. R-CHOP is confirmed as the standard therapy for low risk patients. (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
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