The average relative dose intensity of R-CHOP is an independent factor determining favorable overall survival in diffuse large B-cell lymphoma patients
| Autor: | Wojciech Jurczak, Aleksander B. Skotnicki, Sebastian Szmit, Monika Długosz-Danecka, Tomasz Ogórka |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Oncology Cancer Research Kaplan-Meier Estimate chemotherapy 0302 clinical medicine International Prognostic Index hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols Neoplasm Metastasis Original Research Middle Aged Prognosis Treatment Outcome Vincristine 030220 oncology & carcinogenesis Absolute neutrophil count Female Rituximab Lymphoma Large B-Cell Diffuse medicine.drug Adult medicine.medical_specialty Cyclophosphamide cardiotoxicity Neutropenia 03 medical and health sciences Internal medicine medicine Humans neutropenia Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Proportional Hazards Models business.industry diffuse large B‐cell lymphoma Clinical Cancer Research medicine.disease Regimen 030104 developmental biology Doxorubicin average relative dose intensity Prednisone business Diffuse large B-cell lymphoma Biomarkers |
| Zdroj: | Cancer Medicine |
| Popis: | The prognosis of diffuse large B‐cell lymphoma (DLBCL) patients depends on lymphoma‐ and patient‐related risk factors and is best estimated by the international prognostic index (IPI). The aim of the study was to determine whether the average relative dose intensity (ARDI) of an anthracycline‐containing regimen could predict DLBCL outcome independently from the IPI. We analyzed 223 white Caucasian DLBCL patients who completed at least four cycles of first‐line immunochemotherapy with rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R‐CHOP). The ARDI was calculated by specially developed software in each individual patient, simultaneously with the chemotherapy prescription, which instantly revealed all causes of its decrease. The relevance of the ARDI for progression‐free/overall survival (PFS/OS) was evaluated. Prolonged intervals between cycles of immunochemotherapy—the most common cause of decreased ARDI (49.3%, 110/223)—were due to neutropenia (absolute neutrophil count 90% (P 90% was an IPI‐independent predictor of prolonged PFS (HR = 0.31; 95%CI: 0.20‐0.47; P 90% have significantly better outcome regardless of the IPI; therefore, our official recommendation is an adequate dose density through efficient neutropenia prophylaxis and cardiac protection. |
| Databáze: | OpenAIRE |
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