Dose-dense therapy improves survival in aggressive non-Hodgkin's lymphoma

被引:6
作者
Fridrik, Michael A. [1 ]
Hausmaninger, Hubert [2 ]
Lang, Alois [3 ]
Drach, Johannes [4 ]
Krieger, Otto [5 ]
Geissler, Dietmar [6 ]
Michlmayr, Gerhard [7 ]
Ulsperger, Ernst [8 ]
Chott, Andreas [9 ]
Oberaigner, Wilhelm [10 ]
Greil, Richard [2 ]
机构
[1] Gen Hosp Linz, Ctr Hematol & Med Oncol, Dept Internal Med 3, A-4020 Linz, Austria
[2] Salzburg Univ, Dept Med, A-5020 Salzburg, Austria
[3] LKH, Dept Med, Feldkirch, Austria
[4] Univ Vienna, Internal Dept 1, Vienna, Austria
[5] Kh Elisabethinen, Dept Internal Med 1, Linz, Austria
[6] LKH, Dept Med, Klagenfurt, Austria
[7] Kh Bh Schwestern, Dept Med 1, Linz, Austria
[8] Dept Med Kh, Linz, Austria
[9] Univ Vienna, Dept Pathol, Vienna, Austria
[10] TILAK, Inst Clin Epidemiol, Innsbruck, Austria
关键词
Aggressive non Hodgkin lymphoma; Treatment; Dose-dense; Diffuse large B-cell lymphoma; ELDERLY-PATIENTS; CHOP CHEMOTHERAPY; RANDOMIZED-TRIAL; CELL LYMPHOMAS; RITUXIMAB; INTERMEDIATE; GRADE; ACVBP; DEXA;
D O I
10.1007/s00277-009-0811-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This study aimed to determine whether dose-dense therapy improves 3-year survival over the standard therapy for untreated aggressive lymphoma. One hundred and fifteen patients with untreated aggressive lymphoma were stratified by center, age, and international prognostic index and randomized to one of two treatment arms. One hundred and three were eligible. The experimental dose-dense arm consisted of weekly therapy with cyclophosphamide, epirubicine, vincristine, prednisolone, ifosfamide, etoposide, methotrexate, dexamethasone, and filgrastim (CEOP/IMVP-Dexa). The standard arm consisted of three-weekly cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). The primary endpoint was overall survival after 3 years. Overall survival at 3 years was 0.766 (95% CI 0.6247, 0.8598) in the dose-dense arm and 0.462 (95% CI 0.3200, 0.5925) in the CHOP arm. Overall 5-year survival was 0.746 (95% CI 0.603, 0.843) in the dose dense and 0.406 (95% CI 0.265, 0.543) in the CHOP arm (P = 0.0062). Grade 3 and 4 infections occurred four times more frequently in the dose-dense arm. However, two patients died from toxicity in the dose-dense arm and three in the CHOP arm. Dose-dense therapy with CEOP/IMVP-Dexa is feasible and resulted in an absolute increase of 34% in the survival probability compared to CHOP in untreated patients with aggressive lymphoma.
引用
收藏
页码:273 / 282
页数:10
相关论文
共 25 条
  • [1] Bertini M, 1997, HAEMATOLOGICA, V82, P309
  • [2] SUPERIORITY OF 2ND OVER 1ST GENERATION CHEMOTHERAPY IN A RANDOMIZED TRIAL FOR STAGE-III-IV INTERMEDIATE AND HIGH-GRADE NON-HODGKIN LYMPHOMA (NHL) - THE 1980-1985 EORTC TRIAL
    CARDE, P
    MEERWALDT, JH
    VANGLABBEKE, M
    SOMERS, R
    MONCONDUIT, M
    THOMAS, J
    DEWOLFPEETERS, C
    DEPAUW, B
    TANGUY, A
    KLUINNELEMANS, JC
    NOORDIJK, EM
    REGNIER, R
    BRON, D
    LUSTMANMARECHAL, J
    CAILLOU, B
    BOSQ, J
    VANHEERDE, P
    VANUNNIK, JAM
    BURGERS, JMV
    HAYAT, M
    COSSET, JM
    VANDERSCHUEREN, E
    WAGENER, J
    HAGENBEEK, A
    CATTAN, A
    DUEZ, N
    TUBIANA, M
    [J]. ANNALS OF ONCOLOGY, 1991, 2 (06) : 431 - 435
  • [3] Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas
    Cheson, BD
    Horning, SJ
    Coiffier, B
    Shipp, MA
    Fisher, RI
    Connors, JM
    Lister, TA
    Vose, J
    Grillo-López, A
    Hagenbeek, A
    Cabanillas, F
    Klippensten, D
    Hiddemann, W
    Castellino, R
    Harris, NL
    Armitage, JO
    Carter, W
    Hoppe, R
    Canellos, GP
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1999, 17 (04) : 1244 - 1253
  • [4] CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma.
    Coiffier, B
    Lepage, E
    Brière, J
    Herbrecht, R
    Tilly, H
    Bouabdallah, R
    Morel, P
    Van den Neste, E
    Salles, G
    Gaulard, P
    Reyes, F
    Gisselbrecht, C
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (04) : 235 - 242
  • [5] COX DR, 1972, J R STAT SOC B, V34, P187
  • [6] DEVITA VT, 1975, LANCET, V1, P248
  • [7] COMPARISON OF A STANDARD REGIMEN (CHOP) WITH 3 INTENSIVE CHEMOTHERAPY REGIMENS FOR ADVANCED NON-HODGKINS-LYMPHOMA
    FISHER, RI
    GAYNOR, ER
    DAHLBERG, S
    OKEN, MM
    GROGAN, TM
    MIZE, EM
    GLICK, JH
    COLTMAN, CA
    MILLER, TP
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (14) : 1002 - 1006
  • [8] FISHER RI, 1987, SEMIN HEMATOL, V24, P21
  • [9] Long-term results of dose density therapy in patients with aggressive lymphoma
    Fridrik, M
    Hausmaninger, H
    Linkesch, W
    Greil, R
    Krieger, O
    Baldinger, C
    Klocker, J
    Pont, J
    Oberaigner, W
    [J]. ANNALS OF HEMATOLOGY, 2005, 84 (04) : 217 - 222
  • [10] CEOP-IMVP-DEXA in the treatment of aggressive lymphomas: An Austrian multicenter trial
    Fridrik, MA
    Hausmaninger, H
    Linkesch, W
    Stoger, M
    Sill, H
    Neubauer, M
    Seewann, HL
    Klocker, J
    Haidinger, R
    Schiller, L
    Pont, J
    Raudaschl, G
    Folk, M
    Radaszkiewicz, T
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1996, 14 (01) : 227 - 232