High-Intensity Chemotherapy is Associated with Better Prognosis in Young Patients with High-Risk Diffuse Large B-Cell Lymphoma: A 10-Year Single-Center Retrospective Cohort Study
Xiaorong Ma, Yan Xu, Wanggang Zhang, Jin Wang, Xingmei Cao, Yinxia Chen, Aili He, Jie Liu, Jianli Wang, Wanhong Zhao, Yun Yang
(Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shanxi, China (mainland))
Med Sci Monit 2016; 22:1792-1800
Patients <60 years old with high-risk diffuse large B-cell lymphoma (DLBCL) receiving standard RCHOP(E) treatment display high relapse rates. Here, we compared this standard regimen to a high-intensity regimen in terms of recurrence and long-term survival.
MATERIAL AND METHODS: Newly diagnosed DLBCL patients <60 years old who were treated at the Second Hospital Affiliated with Xi’an Jiaotong University between January 2004 and December 2013 (n=198, 18–60 years) were included in the study. The high-intensity group included 107 patients (54.0%) who received >8 courses of chemotherapy (high-dose CHOP, CHOP-E, EPOCH, MAED, MMED, and HyperCVAD). The control group included 91 patients (46.0%) who received 6–8 courses of CHOP-based treatment. Response rate (RR), survival, relapse, and adverse effects were compared.
RESULTS: Baseline characteristics of the patients were similar between the 2 groups. Median follow-up was 64.5 months. RR in the high-intensity and control groups was 88.8% and 84.6% (P=0.387), respectively; 5-year overall survival was 66.4% and 36.3% (P<0.001), respectively; 5-year progression-free survival was 56.1% and 28.6% (P<0.001), respectively; 5-year disease-free survival was 54.2% and 24.2% (P<0.001), respectively; and relapse rate during follow-up was 29.5% and 67.5% (P<0.001), respectively. There were no significant differences in adverse effects between the 2 groups.
CONCLUSIONS: High-intensity chemotherapy is associated with better prognosis of patients <60 years old with newly diagnosed high-risk DLBCL.
Keywords: Drug Therapy, Drug-Related Side Effects and Adverse Reactions, Lymphoma, B-Cell, Survival Rate