R-CHOP appears to be the best first-line treatment for second primary diffuse large B cell lymphoma: a cancer registry study.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Cyclophosphamide
/ administration & dosage
Doxorubicin
/ administration & dosage
Female
France
/ epidemiology
Humans
Lymphoma, Large B-Cell, Diffuse
/ diagnosis
Male
Middle Aged
Neoadjuvant Therapy
/ methods
Neoplasms, Second Primary
/ diagnosis
Prednisone
/ administration & dosage
Prognosis
Registries
Rituximab
/ administration & dosage
Treatment Outcome
Vincristine
/ administration & dosage
Young Adult
Diffuse large B cell lymphoma
Prior chemotherapy
R-CHOP
Second primary neoplasms
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
04
12
2019
accepted:
19
05
2020
pubmed:
27
5
2020
medline:
24
7
2020
entrez:
27
5
2020
Statut:
ppublish
Résumé
Second primary diffuse large B cell lymphoma (spDLBCL) is defined as a metachronous tumor occurring after a first primary cancer. To date, while R-CHOP is the standard first-line treatment for de novo DLBCL, no available data show that R-CHOP is the optimal treatment for spDLBCL. This exploratory study aimed to investigate treatment of spDLBCL. From 2008 to 2015, the Poitou-Charentes general cancer registry recorded 68 cases of spDLBCL ≤ 80 years old, having received a first-line treatment with either R-CHOP (78%) or other regimens (22%). Patients without R-CHOP have worse overall survival in univariate (HR 2.89 [1.33-6.24], P = 0.007) and multivariate (HR 2.98 [1.34-6.67], P = 0.008) analyses. Patients without R-CHOP more frequently had PS > 1 (67% vs. 28%, P = 0.007) and prior chemotherapy (60% vs. 26%, P = 0.02), which suggests that both of these factors influence a clinician's decision to not use R-CHOP. Prior chemotherapy had no prognostic impact in univariate and multivariate analyses; this result could call into question the risk-benefit balance of not using R-CHOP to prevent toxicity. In our study, one DLBCL out of ten occurred after a first primary cancer, and as regards de novo DLBCL, R-CHOP appeared to be the best first-line treatment. Larger series are needed to confirm these results.
Identifiants
pubmed: 32451709
doi: 10.1007/s00277-020-04100-8
pii: 10.1007/s00277-020-04100-8
doi:
Substances chimiques
Rituximab
4F4X42SYQ6
Vincristine
5J49Q6B70F
Doxorubicin
80168379AG
Cyclophosphamide
8N3DW7272P
Prednisone
VB0R961HZT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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