BACKGROUND: Administration of full-dose R-CHOP (rituximab/cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy is important to maximize response in patients with intermediate-or high-grade non-Hodgkin lymphoma but might be difficult in older patients. PATIENTS AND METHODS: This community-based study was conducted to determine response, toxicity, and disease-free survival in patients with intermediate-or high-grade non-Hodgkin lymphoma receiving R-CHOP with filgrastim. Patients received 6-8 cycles of R-CHOP followed by 4 cycles of maintenance rituximab for responders. Patients aged > 60 years or with increased infection risk received filgrastim 5 microg/kg per day in all R-CHOP cycles; other patients received filgrastim after a neutropenic event (no planned administration for cycle 1). RESULTS: Of 101 patients enrolled, 60 (59%) were aged > 60 years and received filgrastim in all cycles. Thirty-three patients aged <or= 60 years (80%) received filgrastim, 7 (17%) as primary use in cycle 1. Chemotherapy average relative dose intensity was comparable between age groups (91% > 60 years vs. 93% <or= 60 years). Overall response was similar in both groups (87% > 60 years vs. 95% <or= 60 years; P=0.19); however, the complete response rate was significantly lower for older patients (42% > 60 years vs. 71% <or= 60 years; P=0.005). Seventy-six percent of patients (75% > 60 years vs. 78% <or= 60 years) had no evidence of progression after 2 years of follow-up. Febrile neutropenia (fever >or= 38.3 degrees C with absolute neutrophil count < 500/mm) occurred in 17% of patients overall (22% > 60 years vs. 10% <or= 60 years), and 8% had cycle-1 events (12% > 60 years vs. 2% <or= 60 years). CONCLUSION: Patients aged > 60 years receiving R-CHOP with filgrastim support in all cycles received comparable doses of chemotherapy and had similar overall response rates compared wtih those of younger patients receiving no preemptive cycle-1 filgrastim.
BACKGROUND: Administration of full-dose R-CHOP (rituximab/cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy is important to maximize response in patients with intermediate-or high-grade non-Hodgkin lymphoma but might be difficult in older patients. PATIENTS AND METHODS: This community-based study was conducted to determine response, toxicity, and disease-free survival in patients with intermediate-or high-grade non-Hodgkin lymphoma receiving R-CHOP with filgrastim. Patients received 6-8 cycles of R-CHOP followed by 4 cycles of maintenance rituximab for responders. Patients aged > 60 years or with increased infection risk received filgrastim 5 microg/kg per day in all R-CHOP cycles; other patients received filgrastim after a neutropenic event (no planned administration for cycle 1). RESULTS: Of 101 patients enrolled, 60 (59%) were aged > 60 years and received filgrastim in all cycles. Thirty-three patients aged <or= 60 years (80%) received filgrastim, 7 (17%) as primary use in cycle 1. Chemotherapy average relative dose intensity was comparable between age groups (91% > 60 years vs. 93% <or= 60 years). Overall response was similar in both groups (87% > 60 years vs. 95% <or= 60 years; P=0.19); however, the complete response rate was significantly lower for older patients (42% > 60 years vs. 71% <or= 60 years; P=0.005). Seventy-six percent of patients (75% > 60 years vs. 78% <or= 60 years) had no evidence of progression after 2 years of follow-up. Febrile neutropenia (fever >or= 38.3 degrees C with absolute neutrophil count < 500/mm) occurred in 17% of patients overall (22% > 60 years vs. 10% <or= 60 years), and 8% had cycle-1 events (12% > 60 years vs. 2% <or= 60 years). CONCLUSION:Patients aged > 60 years receiving R-CHOP with filgrastim support in all cycles received comparable doses of chemotherapy and had similar overall response rates compared wtih those of younger patients receiving no preemptive cycle-1 filgrastim.
Authors: Ruth Pettengell; Hans E Johnsen; Hans E Johnson; Pieternella J Lugtenburg; Antonio Salar Silvestre; Ulrich Dührsen; Francesca G Rossi; Matthias Schwenkglenks; Kate Bendall; Zsolt Szabo; Ulrich Jaeger Journal: Support Care Cancer Date: 2011-11-20 Impact factor: 3.603
Authors: Yong Won Choi; Seong Hyun Jeong; Mi Sun Ahn; Hyun Woo Lee; Seok Yun Kang; Jin-Hyuk Choi; U Ram Jin; Joon Seong Park Journal: J Korean Med Sci Date: 2014-11-04 Impact factor: 2.153
Authors: Claire Dendle; Michael Gilbertson; Tim Spelman; Rhonda L Stuart; Tony M Korman; Karin Thursky; Stephen Opat; Zoe McQuilten Journal: Sci Rep Date: 2017-06-30 Impact factor: 4.379