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Impact of relative dose intensity (RDI) in CHOP combined with rituximab (R-CHOP) on survival in diffuse large B-cell lymphoma.

Terada Y, Nakamae H, Aimoto R, Kanashima H, Sakamoto E, Aimoto M, Inoue E, Koh H, Nakane T, Takeoka Y, Ohsawa M, Koh KR, Yamane T, Nakao Y, Ohta K, Mugitani A, Teshima H, Hino M - J. Exp. Clin. Cancer Res. (2009)

Bottom Line: A multivariate Cox regression model showed that RDI trended towards a significant association with mortality [hazard ratio per 0.1 of RDI = 0.8; 95% confidence interval 0.6-1.0; P = 0.08].Additionally, on multivariate logistic analysis, advanced age was a significant factor for reduced RDI.Our data suggest that in DLBL patients, mortality was affected by RDI of R-CHOP as the initial treatment, and the retention of a high RDI could therefore be crucial.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan. teraday@med.osaka-cu.ac.jp

ABSTRACT

Background: Recently, maintaining higher relative dose intensity (RDI) of chemotherapeutic drugs has become a widespread practice in an attempt to achieve better outcomes in the treatment of aggressive lymphoma. The addition of rituximab to chemotherapy regimens has significantly improved outcome in diffuse large B-cell lymphoma (DLBL). However, it is unknown if higher RDI in chemotherapy when combined with rituximab leads to a better outcome in aggressive B-cell lymphoma.

Methods: We retrospectively evaluated the impact of the RDI of initial chemotherapy (consisting of cyclophosphamide, doxorubicin, vincristine and prednisolone with rituximab (R-CHOP) on outcome in 100 newly diagnosed DLBL patients.

Results: A multivariate Cox regression model showed that RDI trended towards a significant association with mortality [hazard ratio per 0.1 of RDI = 0.8; 95% confidence interval 0.6-1.0; P = 0.08]. Additionally, on multivariate logistic analysis, advanced age was a significant factor for reduced RDI.

Conclusion: Our data suggest that in DLBL patients, mortality was affected by RDI of R-CHOP as the initial treatment, and the retention of a high RDI could therefore be crucial.

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Related in: MedlinePlus

Overall survival curves of the higher RDI (≥ median) and the lower RDI (< median) group. RDI: relative dose intensity (RDI) of R-CHOP chemotherapy.
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Figure 1: Overall survival curves of the higher RDI (≥ median) and the lower RDI (< median) group. RDI: relative dose intensity (RDI) of R-CHOP chemotherapy.

Mentions: We registered 14 deaths. With a median follow-up of 21.2 months, the three-year OS in all cases, in the group with a higher RDI (above the median) and in the group with a lower RDI (below the median) was 81.6%, 92.1% and 74.2%, respectively (Figure 1). The three-year PFS in all cases, in the group with a higher RDI (above the median) and in the group with a lower RDI (below the median) was 56.3%, 58.7% and 54.0%, respectively.


Impact of relative dose intensity (RDI) in CHOP combined with rituximab (R-CHOP) on survival in diffuse large B-cell lymphoma.

Terada Y, Nakamae H, Aimoto R, Kanashima H, Sakamoto E, Aimoto M, Inoue E, Koh H, Nakane T, Takeoka Y, Ohsawa M, Koh KR, Yamane T, Nakao Y, Ohta K, Mugitani A, Teshima H, Hino M - J. Exp. Clin. Cancer Res. (2009)

Overall survival curves of the higher RDI (≥ median) and the lower RDI (< median) group. RDI: relative dose intensity (RDI) of R-CHOP chemotherapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2743657&req=5

Figure 1: Overall survival curves of the higher RDI (≥ median) and the lower RDI (< median) group. RDI: relative dose intensity (RDI) of R-CHOP chemotherapy.
Mentions: We registered 14 deaths. With a median follow-up of 21.2 months, the three-year OS in all cases, in the group with a higher RDI (above the median) and in the group with a lower RDI (below the median) was 81.6%, 92.1% and 74.2%, respectively (Figure 1). The three-year PFS in all cases, in the group with a higher RDI (above the median) and in the group with a lower RDI (below the median) was 56.3%, 58.7% and 54.0%, respectively.

Bottom Line: A multivariate Cox regression model showed that RDI trended towards a significant association with mortality [hazard ratio per 0.1 of RDI = 0.8; 95% confidence interval 0.6-1.0; P = 0.08].Additionally, on multivariate logistic analysis, advanced age was a significant factor for reduced RDI.Our data suggest that in DLBL patients, mortality was affected by RDI of R-CHOP as the initial treatment, and the retention of a high RDI could therefore be crucial.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan. teraday@med.osaka-cu.ac.jp

ABSTRACT

Background: Recently, maintaining higher relative dose intensity (RDI) of chemotherapeutic drugs has become a widespread practice in an attempt to achieve better outcomes in the treatment of aggressive lymphoma. The addition of rituximab to chemotherapy regimens has significantly improved outcome in diffuse large B-cell lymphoma (DLBL). However, it is unknown if higher RDI in chemotherapy when combined with rituximab leads to a better outcome in aggressive B-cell lymphoma.

Methods: We retrospectively evaluated the impact of the RDI of initial chemotherapy (consisting of cyclophosphamide, doxorubicin, vincristine and prednisolone with rituximab (R-CHOP) on outcome in 100 newly diagnosed DLBL patients.

Results: A multivariate Cox regression model showed that RDI trended towards a significant association with mortality [hazard ratio per 0.1 of RDI = 0.8; 95% confidence interval 0.6-1.0; P = 0.08]. Additionally, on multivariate logistic analysis, advanced age was a significant factor for reduced RDI.

Conclusion: Our data suggest that in DLBL patients, mortality was affected by RDI of R-CHOP as the initial treatment, and the retention of a high RDI could therefore be crucial.

Show MeSH
Related in: MedlinePlus