Xin-Yu Zhang1,2, Jin-Hua Liang1,2, Li Wang1,2, Hua-Yuan Zhu1,2, Wei Wu1,2, Lei Cao1,2, Lei Fan1,2, Jian-Yong Li1,2, Wei Xu3,4. 1. Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China. 2. Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 210029, China. 3. Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China. xuwei10000@hotmail.com. 4. Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 210029, China. xuwei10000@hotmail.com.
Abstract
PURPOSE: This study was to compare DA-EPOCH-R and R-CHOP regimen as first-line therapy in diffuse large B cell lymphoma (DLBCL) patients, retrospectively. METHODS: A total of 252 cases treated with R-CHOP and 146 cases who received DA-EPOCH-R were enrolled into this study. RESULTS: Overall, 162 (64.3%) and 105 patients (71.9%) achieved complete remission, 43 (17.1%) and 14 patients (9.6%) achieved partial remission following R-CHOP and DA-EPOCH-R regimen, respectively. After a median follow-up of 48 months, better progression-free survival (PFS) was seen in DA-EPOCH-R group, but no better overall survival (OS) was found in patients treated with DA-EPOCH-R compared to R-CHOP (P = 0.015 for PFS, P = 0.19 for OS). However, subgroup analysis according to cell of origin, international prognostic index (IPI), and age showed DA-EPOCH-R resulted in significantly better PFS and OS than R-CHOP regimen in patients with germinal center B-cell-like (GCB) phenotype (P = 0.002 for PFS, P = 0.007 for OS), high IPI (P = 0.002 for PFS; P = 0.03 for OS), and with a younger age (P = 0.002 for PFS, P = 0.045 for OS). We also compared two regimens in patients with double expressor lymphoma (DEL). The prognosis of DEL patients was significantly worse than non-DEL patients (P < 0.001 for PFS, P < 0.001 for OS), but DA-EPOCH-R regimen may not overcome the poor prognosis (P = 0.47 for PFS, P = 0.79 for OS). CONCLUSION: GCB DLBCL, younger patients, and high-risk patients, but not DEL patients, may benefit from continuous-infusion DA-EPOCH-R regimen.
PURPOSE: This study was to compare DA-EPOCH-R and R-CHOP regimen as first-line therapy in diffuse large B cell lymphoma (DLBCL) patients, retrospectively. METHODS: A total of 252 cases treated with R-CHOP and 146 cases who received DA-EPOCH-R were enrolled into this study. RESULTS: Overall, 162 (64.3%) and 105 patients (71.9%) achieved complete remission, 43 (17.1%) and 14 patients (9.6%) achieved partial remission following R-CHOP and DA-EPOCH-R regimen, respectively. After a median follow-up of 48 months, better progression-free survival (PFS) was seen in DA-EPOCH-R group, but no better overall survival (OS) was found in patients treated with DA-EPOCH-R compared to R-CHOP (P = 0.015 for PFS, P = 0.19 for OS). However, subgroup analysis according to cell of origin, international prognostic index (IPI), and age showed DA-EPOCH-R resulted in significantly better PFS and OS than R-CHOP regimen in patients with germinal center B-cell-like (GCB) phenotype (P = 0.002 for PFS, P = 0.007 for OS), high IPI (P = 0.002 for PFS; P = 0.03 for OS), and with a younger age (P = 0.002 for PFS, P = 0.045 for OS). We also compared two regimens in patients with double expressor lymphoma (DEL). The prognosis of DEL patients was significantly worse than non-DEL patients (P < 0.001 for PFS, P < 0.001 for OS), but DA-EPOCH-R regimen may not overcome the poor prognosis (P = 0.47 for PFS, P = 0.79 for OS). CONCLUSION: GCB DLBCL, younger patients, and high-risk patients, but not DEL patients, may benefit from continuous-infusion DA-EPOCH-R regimen.
Entities:
Keywords:
DA-EPOCH-R; Diffuse large B cell lymphoma; Prognosis; R-CHOP; Therapy
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