Long-Term Follow-Up of a Phase II Trial of Six Cycles of Dose-Dense R-CHOP-14 for First-Line Treatment of Diffuse Large B-Cell Lymphoma in Young and Elderly Patients
Por:
Gonzalez-Barca, E, Canales, MA, Salar, A, Ferrer, S, Domingo-Domenech, E, Vidal, MJ, Grande, C, Bargay, J, Gardella, S, Oriol, A, Briones, J, Garcia-Frade, J, Bello, JL, Sanchez-Blanco, JJ, Penalver, FJ, Tomas, JF, Asensio, A, Lopez, A, Caballero, D
Publicada:
1 ene 2016
Resumen:
Background/Aims: Rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 14 days seems to achieve better outcomes than R-CHOP every 21 days in diffuse large B-cell lymphoma (DLBCL) patients. Currently, the standard regimen is R-CHOP every 21 days. Methods: This is a phase II clinical trial of treatment with 6 cycles of R-CHOP-14 with pegfilgrastim support in 2 populations of previously untreated DLBCL patients aged >= 65 years (n = 73) or <65 years (n = 51) with low-risk International Prognostic Index scores (0-2). Results: With a median follow-up of 63.7 months, the 5-year event-free survival rate was 53.8% in patients aged >= 65 years and 71.0% in patients aged <65 years. The 5-year overall survival rate was 71.4 and 89.8%, respectively. The complete remission rate was 69.9% for older and 80.4% for younger patients. The median relative dose intensity of cytotoxic drugs was 143.2% in the elderly and 149.1% in the young patients. Febrile neutropenia was the most common grade 3-4 adverse event, being higher in elderly patients (21.3 vs. 9.3%). Eight deaths (7 in elderly patients) were considered treatment related. Conclusion: In conclusion, the R-CHOP-14 regimen is feasible and very active, though it is more toxic in elderly patients mainly due to an increased incidence of infections. New strategies, such as new monoclonal antibodies or new targeted therapies, are needed to improve the outcomes of DLBCL patients. (C) 2016 S. Karger AG, Basel
Filiaciones:
Gonzalez-Barca, E:
IDIBELL, Hosp Duran & Reynals, Inst Catala Oncol, Barcelona, Spain
Canales, MA:
Hosp Univ La Paz, Madrid, Spain
Salar, A:
Hosp del Mar, Barcelona, Spain
Ferrer, S:
Hosp Univ Dr Peset, Valencia, Spain
Domingo-Domenech, E:
IDIBELL, Hosp Duran & Reynals, Inst Catala Oncol, Barcelona, Spain
Vidal, MJ:
Hosp Univ Donostia, Donostia San Sebastian, Spain
Grande, C:
Hosp Univ 12 Octubre, Madrid, Spain
Bargay, J:
Hosp Son Llatzer, Palma De Mallorca, Spain
Gardella, S:
Hosp Dr Josep Trueta, Girona, Spain
Oriol, A:
Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol, Barcelona, Spain
Briones, J:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Garcia-Frade, J:
Hosp Univ Rio Hortega, Valladolid, Spain
Bello, JL:
Complejo Hosp Univ Santiago, Santiago, Spain
Sanchez-Blanco, JJ:
Univ Morales Meseguer, Gen Hosp, Murcia, Spain
Penalver, FJ:
Hosp Univ Fdn Alcorcon, Madrid, Spain
Tomas, JF:
MD Anderson, Madrid, Spain
Asensio, A:
Hosp Residencia St Camil, St Pere De Ribes, Spain
Lopez, A:
Hosp Univ Vall Hebron, Barcelona, Spain
Caballero, D:
Univ Salamanca, Hosp Clin, Salamanca, Spain
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