Impact of intended and relative dose intensity of R-CHOP in a large, consecutive cohort of elderly diffuse large B-cell lymphoma patients treated with curative intent: no difference in cumulative incidence of relapse comparing patients by age

Journal of Internal Medicine
Toby A EyreChris S R Hatton

Abstract

The increasing incidence of diffuse large B-cell lymphoma (DLBCL) in ageing populations places a significant burden on healthcare systems. Co-morbidity, frailty, and reduced organ and physiological reserve contribute to treatment-related complications. The optimal dose intensity of R-CHOP to optimize outcome across different ages with variable frailty and comorbidity burden is unclear. We examined the influence of intended (IDI) and relative (RDI) dose intensity of the combination of cyclophosphamide and doxorubicin, age and comorbidity on outcomes for DLBCL patients ≥70 years in a representative, consecutive cohort across eight UK centres (2009-2018). We determined predictors of survival using multivariable Cox regression, and predictors of recurrence before death using competing risks regression. Porgression-free survival (PFS) and overall survival (OS) were significantly inferior in patients ≥80 vs. 70-79 years (P < 0.001). In contrast, 2-year cumulative relapse incidence, when accounting for non-relapse mortality as a competing risk, was no different between 70-79 vs. ≥80 years (P = 0.27) or comorbidity status (CIRS-G: 0-6 vs. >6) (P = 0.27). In 70-79 years, patients with an IDI ≥80% had a significantly improved PFS and OS ...Continue Reading

References

Jan 25, 2002·The New England Journal of Medicine·Bertrand CoiffierChristian Gisselbrecht
Jun 7, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Thomas M HabermannSandra J Horning
Jan 30, 2008·The Lancet Oncology·Michael PfreundschuhUNKNOWN German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL)
May 1, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Benjamin D SmithThomas A Buchholz
Aug 20, 2009·Journal of Experimental & Clinical Cancer Research : CR·Yoshiki TeradaMasayuki Hino
Mar 30, 2010·Journal of the American Geriatrics Society·Sarah D BerryDouglas P Kiel
Apr 13, 2011·The Lancet Oncology·Frédéric PeyradeUNKNOWN Groupe d'Etude des Lymphomes de l'Adulte (GELA) investigators
Jun 24, 2018·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Maja Bech JuulThomas Stauffer Larsen

❮ Previous
Next ❯

Citations

Jun 12, 2020·Journal of Cancer Research and Clinical Oncology·Masakazu YamamotoKatsushi Tajima
Oct 2, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Adam S KittaiAlexey V Danilov
Feb 23, 2021·British Journal of Haematology·Xiao-Yin ZhangToby A Eyre
May 8, 2021·Blood Advances·Edward J BataillardTarec Christoffer El-Galaly
May 28, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ashley E RoskoHeidi D Klepin
Mar 14, 2021·British Journal of Haematology·Raul CordobaToby A Eyre

❮ Previous
Next ❯

Related Concepts

Related Feeds

B-Cell Lymphoma

B-cell lymphomas include lymphomas that affect B cells. This subtype of cancer accounts for over 80% of non-Hodgkin lymphomas in the US. Here is the latest research.