scholarly journals Impact of Pegfilgrastim Approval on Relative Dose Intensity and Outcomes of R-CHOP for Diffuse Large B-Cell Lymphoma

2021 ◽  
Author(s):  
Yuka Morita ◽  
Yusuke Kanemasa ◽  
Yuki Sasaki ◽  
An Ohigashi ◽  
Taichi Tamura ◽  
...  
Keyword(s):  
High Risk ◽  
B Cell ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Risk Groups ◽  
Relative Dose Intensity ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Maintaining the relative dose intensity (RDI) of chemotherapy with R-CHOP improves the prognosis of patients with diffuse large B-cell lymphoma (DLBCL). Pegfilgrastim was approved for use in Japan in November 2014 to prevent febrile neutropenia (FN) and maintain RDI. We herein reviewed 334 patients with DLBCL who received six or more courses of R-CHOP and retrospectively analyzed the difference in the RDI, overall survival (OS), and progression-free survival (PFS) between patients whose treatment started after November 2014 (the post-approval group) and those whose treatment started before October 2014 (the pre-approval group). The incidence of FN was lower (39.2% vs. 62.2%, P < 0.001) and the RDI of R-CHOP was higher (86.8% vs. 67.8%, P < 0.001) in the post-approval group. The RDI of patients aged < 70 years was maintained at a high level even if their RDI was predicted to be low based on the model derived from the pre-approval group. Pegfilgrastim was administered to many of these patients and was thought to have contributed to the high RDI maintenance in the post-approval group. The 5-year OS (85.7% and 69.9%, P = 0.009) and PFS (81.4% and 64.4%, P = 0.011) were superior in the post-approval group. In this group, improved survival outcomes were observed among patients with Ann Arbor stage 3/4 (5-year OS: 83.7% vs. 61.3%, P = 0.019) and high risk on the NCCN-IPI (5-year OS: 80.7% vs. 32.4%, P = 0.014). Maintenance of high RDI of R-CHOP and significant improvement in clinical outcomes, especially in high-risk groups, were observed after pegfilgrastim approval.

The impacts of initial and relative dose intensity of R-CHOP on outcomes of elderly patients with diffuse large B-cell lymphoma

2016 ◽  
Vol 58 (3) ◽  
pp. 736-739 ◽  
Author(s):  
Yusuke Kanemasa ◽  
Tatsu Shimoyama ◽  
Yuki Sasaki ◽  
Miho Tamura ◽  
Takeshi Sawada ◽  
...  
Keyword(s):  
Elderly Patients ◽  
B Cell ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Large B Cell Lymphoma ◽  
Large B Cell

The Impact of Relative Dose Intensity (RDI) of CHOP on Outcome of Diffuse Large B-Cell Lymphoma: Results of a Single Center Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4456-4456
Author(s):  
Yoshiki Terada ◽  
Hirohisa Nakamae ◽  
Takahiko Nakane ◽  
Hideo Koh ◽  
Yasunobu Takeoka ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Outcomes ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Abstract Introduction: The achievement of a clinical response to the first induction chemotherapy has been considered for predicting survival in patients (pts) with aggressive non-Hodgkin lymphoma (NHL). Reduced dose intensity of chemotherapy has been likely to compromise long-term outcome of the patients with aggressive NHL treated with a standard chemotherapy of cyclophosphamide (CY), doxorubicin (ADR), vincristine and prednisone (CHOP). In particular, recent studies have revealed the relevance of relative dose intensity (RDI) to clinical outcomes, with reduced RDI leading to a poor survival, as well as the impact of RDI<85% for aggressive NHL with detailed analysis of risk factors influencing reduce RDI<85% (Gary H. Lyman, J. Clin Oncol22: 4302, 2004). This study was conducted to investigate the impact of RDI<85% of CHOP on outcomes of the pts with diffuse large B-Cell lymphoma (DLCL). Methods: Data were retrospectively collected on 100 pts with DLCL who had been initially treated with more than 3 courses of CHOP (n=70) or CHOP plus rituximab (CHOP-R, n=30) at our institution between 1995 and 2006. We evaluated whether RDI might affect clinical outcomes, including complete response (CR) and event free survival (EFS). The average RDI derived from CY and ADR (referred to as RDI-CY/ADR) was determined for each patient, with classified into 2 populations according to the differences from the value of 85%, including RDI-CY/ADR<85% (n=60), and RDI-CY/ADR≥85% (n=40). Results: The median age of the study population was 54 years (range, 17 to 76), with 36 pts older than 60 years (yrs) of age. According to International Prognostic Index (IPI) score, pts were classified into 2 groups of low/ low-intermediate (n=46) and high/ high-intermediate (n=54). The overall CR rate reached 62%, and the probability of overall survival (OS) or EFS at 5 years estimated 77% or 43%, respectively with a median follow-up of 13.3 months. Multivariate analysis identified RDI-CY/ADR<85%, as well as IPI score to be associated with CR rate and EFS. Thus, RDI-CY/ADR<85% and IPI score of high/ high-intermediate were significant factors for lower CR rate (as RDI-CY/ADR≥85%, HR=0.3, 95% CI 0.1 to 0.7, p=0.009, and HR=5.5, 95% CI 2.2 to 14, p<0.001, respectively), and for reduced EFS (HR=1.9, 95% CI 1.0 to 3.7, p=0.048, and as IPI score of low/ low-intermediate HR=0.3, 95% CI 0.2 to 0.6, p<0.001, respectively). Furthermore, logrank analysis revealed that CY/ADR-RDI<85% was the significant factor for reduced EFS in non elderly pts (≤60 yrs of age), or in pts with IPI score of low/ low-intermediate (p=0.01, p=0.02, respectively). Conclusion: These data thus suggested the impact of RDI-CY/ADR<85% in influencing outcomes of the pts with DLCL, in terms of CR rate and EFS. Further investigation is currently planned to confirm this promising results with longer follow-up in larger numbers of pts with NHL.

Prognosis of mature T cell lymphoma is poorer than that of diffuse large B cell lymphoma in IPI low-risk group, but not in intermediate- and high-risk groups

2012 ◽  
Vol 97 (1) ◽  
pp. 98-102 ◽  
Author(s):  
Rika Kihara ◽  
Tomoyuki Watanabe ◽  
Takahiro Yano ◽  
Naokuni Uike ◽  
Seiichi Okamura ◽  
...  
Keyword(s):  
T Cell ◽  
High Risk ◽  
B Cell ◽  
Cell Lymphoma ◽  
Risk Group ◽  
B Cell Lymphoma ◽  
Risk Groups ◽  
Low Risk ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals The average relative dose intensity of R‐CHOPis an independent factor determining favorable overall survival in diffuse large B‐cell lymphoma patients

2019 ◽  
Vol 8 (3) ◽  
pp. 1103-1109 ◽  
Author(s):  
Monika Długosz‐Danecka ◽  
Sebastian Szmit ◽  
Tomasz Ogórka ◽  
Aleksander B. Skotnicki ◽  
Wojciech Jurczak
Keyword(s):  
Overall Survival ◽  
B Cell ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Independent Factor ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Prognostic impact of immunohistochemically defined germinal center phenotype in diffuse large B-cell lymphoma patients treated with immunochemotherapy

Blood ◽  
2007 ◽  
Vol 109 (11) ◽  
pp. 4930-4935 ◽  
Author(s):  
Heidi Nyman ◽  
Magdalena Adde ◽  
Marja-Liisa Karjalainen-Lindsberg ◽  
Minna Taskinen ◽  
Mattias Berglund ◽  
...  
Keyword(s):  
High Risk ◽  
B Cell ◽  
Germinal Center ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Risk Groups ◽  
Control Group ◽  
Prognostic Impact ◽  
Large B Cell Lymphoma ◽  
Large B Cell

AbstractGerminal center (GC) and non-GC phenotypes are predictors of outcome in diffuse large B-cell lymphoma (DLBCL) and can be used to stratify chemotherapy-treated patients into low- and high-risk groups. To determine how combination of rituximab with chemotherapy influences GC-associated clinical outcome, GC and non-GC phenotypes were identified immunohistochemically from samples of 90 de novo DLBCL patients treated with rituximab in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)–like regimen (immunochemotherapy). One hundred and four patients previously treated with chemotherapy served as a control group. Consistent with previous studies, chemotherapy-treated patients with immunohistochemically defined GC phenotype displayed a significantly better overall (OS) and failure-free survival (FFS) than the non-GC group (OS, 70% vs 47%, P = .012; FFS, 59% vs 30%, P = .001). In contrast, immunohistochemically defined GC phenotype did not predict outcome in immunochemotherapy-treated patients (OS, 77% vs 76%, P = ns; FFS, 68% vs 63%, P = ns). In comparison, International Prognostic Index (IPI) could separate the high-risk patients from low- and intermediate-risk groups (OS, 84% vs 63%, P = .030; FFS, 79% vs 52%, P = .028). We conclude that rituximab in combination with chemotherapy seems to eliminate the prognostic value of immunohistochemically defined GC- and non-GC phenotypes in DLBCL.

scholarly journals Differential Impact of Relative Dose-Intensity Reductions in Diffuse Large B-Cell Lymphoma Treated with R-CHOP21 or R-CHOP14

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0123978 ◽  
Author(s):  
Antonio Gutiérrez ◽  
Leyre Bento ◽  
Antonia Maria Bautista-Gili ◽  
Francesc Garcia ◽  
Jordi Martinez-Serra ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Differential Impact ◽  
Large B Cell Lymphoma ◽  
Large B Cell
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