R-CHOEP14 in younger high-risk patients with large B cell lymphoma: an effective front-line regimen with cardiac toxicity: a real-life, single-center experience.
Adult
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Cyclophosphamide
/ adverse effects
Doxorubicin
/ adverse effects
Etoposide
/ adverse effects
Female
Follow-Up Studies
Humans
Lymphoma, Large B-Cell, Diffuse
/ drug therapy
Male
Middle Aged
Progression-Free Survival
Retrospective Studies
Rituximab
/ adverse effects
Steroids
/ adverse effects
Treatment Outcome
Vincristine
/ adverse effects
Young Adult
Chemotherapy
Etoposide
Lymphoma, Large B cell, Diffuse
R-CHOEP
Rituximab
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
25
06
2020
accepted:
17
11
2020
pubmed:
21
11
2020
medline:
27
5
2021
entrez:
20
11
2020
Statut:
ppublish
Résumé
Currently, there is no consensus regarding optimal front-line treatment for younger high-risk patients with large B cell lymphoma. American recommendations list only R-CHOP as standard, while European also include R-ACVBP and R-CHOEP14. We have been routinely using the latter regimen at our institution since 2011 and performed this retrospective real-life single-center study to analyze outcomes. Between September 2011 and April 2019, 66 newly diagnosed patients aged 18 to 60 years with B-large cell lymphoma and high-risk age-adjusted International Prognostic Index score were scheduled to receive 6 or 8 cycles of bi-weekly chemoimmunotherapy with cyclophosphamide, doxorubicin, vincristine, etoposide, steroids, and rituximab (R-CHOEP14). After a median follow-up of 4.7 years, the estimated 3-year progression-free survival was 87% (95% CI 80-96%) and 3-year overall survival 90% (95% CI 83-98%). Grade ≥ 3 hematological side effects occurred in 83% and infectious in 41% of patients; one patient died of toxicity. Grade ≥ 2 cardiac toxicity occurred in 21% of patients, more frequently than previously reported. The cumulative 5-year risk of congestive heart failure with all-cause mortality as the competing risk was 17%. R-CHOEP14 is a very effective and manageable regimen for younger high-risk patients with B-large cell lymphoma, but the risk of cardiotoxicity warrants further investigations.
Identifiants
pubmed: 33216199
doi: 10.1007/s00277-020-04353-3
pii: 10.1007/s00277-020-04353-3
doi:
Substances chimiques
Steroids
0
Rituximab
4F4X42SYQ6
Vincristine
5J49Q6B70F
Etoposide
6PLQ3CP4P3
Doxorubicin
80168379AG
Cyclophosphamide
8N3DW7272P
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1517-1524Subventions
Organisme : Medicinski Fakultet, Sveučilište u Zagrebu
ID : 1118002 and 1119002
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