CHOP compared with CHOP plus granulocyte colony-stimulating factor in elderly patients with aggressive non-Hodgkin's lymphoma
| Autor: | Andries H. Mulder, M. R. Schaafsma, Pieter Sonneveld, J.K. Doorduijn, L. F. Verdonck, M van Agthoven, Monique Steijaert, C.A. Uyl-de Groot, K. G. van der Hem, Gert J. Ossenkoppele, Gregor Verhoef, G. W. van Imhoff, B. van der Holt, M. H. J. Van Oers, M. H. H. Kramer, I. Buijt |
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| Přispěvatelé: | Stem Cell Aging Leukemia and Lymphoma (SALL), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Hematology, Erasmus School of Health Policy & Management, BV's, Pathology, Clinical Haematology |
| Rok vydání: | 2003 |
| Předmět: |
Male
Cancer Research Vincristine medicine.medical_specialty Cyclophosphamide genetic structures medicine.medical_treatment EUROPEAN-ORGANIZATION PATIENTS OLDER Neutropenia CHOP Gastroenterology LARGE-CELL LYMPHOMA AGE Prednisone NEUTROPENIA immune system diseases Internal medicine hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols Granulocyte Colony-Stimulating Factor medicine COMBINATION CHEMOTHERAPY REGIMEN STANDARD REGIMEN Humans Aged Chemotherapy business.industry Lymphoma Non-Hodgkin medicine.disease CANCER Lymphoma Surgery Non-Hodgkin's lymphoma GRADE Treatment Outcome Oncology Doxorubicin Quality of Life DIFFUSE HISTIOCYTIC LYMPHOMA Female business medicine.drug |
| Zdroj: | Journal of Clinical Oncology, 21(16), 3041-3050. AMER SOC CLINICAL ONCOLOGY Journal of Clinical Oncology, 21(16), 3041-3050. American Society of Clinical Oncology Journal of clinical oncology, 21(16), 3041-3050. American Society of Clinical Oncology |
| ISSN: | 0732-183X |
| DOI: | 10.1200/jco.2003.01.076 |
| Popis: | Purpose: To investigate whether the relative dose-intensity of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy could be improved by prophylactic administration of granulocyte colony-stimulating factor (G-CSF) in elderly patients with aggressive non-Hodgkin’s lymphoma (NHL). Patients and Methods: Patients aged 65 to 90 years (median, 72 years) with stage II to IV aggressive NHL were randomly assigned to receive standard CHOP every 3 weeks or CHOP plus G-CSF every 3 weeks on days 2 to 11 of each cycle. Results: In 389 eligible patients, the relative dose intensities (RDIs) of cyclophosphamide (median, 96.3% v 93.9%; P = .01) and doxorubicin (median, 95.4% v 93.3%; P = .04) were higher in patients treated with CHOP plus G-CSF. The complete response rates were 55% and 52% for CHOP and CHOP plus G-CSF, respectively (P = .63). The actuarial overall survival at 5 years was 22% with CHOP alone, compared with 24% with CHOP plus G-CSF (P = .76), with a median follow-up of 33 months. Patients treated with CHOP plus G-CSF had an identical incidence of infections, with World Health Organization grade 3 to 4 (34 of 1,191 cycles v 36 of 1,195 cycles). Only the cumulative days with antibiotics were fewer with CHOP plus G-CSF (median, 0 v 6 days; P = .006) than with CHOP alone. The number of hospital admissions and the number of days in hospital were not different. Conclusion: In elderly patients, G-CSF improved the RDI of CHOP, but this did not lead to a higher complete response rate or better overall survival. G-CSF did not prevent serious infections. |
| Databáze: | OpenAIRE |
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