Influence of dose reduction of vincristine in R-CHOP on outcomes of diffuse large B cell lymphoma
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- 作者：Yoshikazu Utsu ; Koji Takaishi ; Shunichirou Inagaki ; Hironori Arai…
- 关键词：Diffuse large B cell lymphoma ; Chemotherapy ; Dose intensity ; R ; CHOP ; Vincristine
- 刊名：Annals of Hematology
- 出版年：2016
- 出版时间：January 2016
- 年：2016
- 卷：95
- 期：1
- 页码：41-47
- 全文大小：939 KB
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Koji Takaishi (1)
Shunichirou Inagaki (1)
Hironori Arai (1)
Hiromi Yuasa (1)
Shinichi Masuda (1)
Yasuhiro Matsuura (1)
Nobuyuki Aotsuka (1)
Hisashi Wakita (1)
1. Department of Hematology and Oncology, Japanese Red Cross Narita Hospital, 90-1 Iida-cho, Narita, 286-8523, Japan - 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Hematology
Oncology - 出版者：Springer Berlin / Heidelberg
- ISSN：1432-0584
文摘
Dose intensity (DI) of chemotherapy affects prognosis of diffuse large B cell lymphoma (DLBCL). Myelotoxicity is the major dose-limiting toxicity (DLT) of most cytotoxic agents for hematological malignancies, whereas DLT of vincristine (VCR) is mainly neurological toxicity. Although VCR is a key drug and its combination with other cytotoxic agents needs consideration, studies focused on relative DI (RDI) of VCR have not been done before. We retrospectively analyzed 86 cases of DLBCL that received six or more cycles of cyclophosphamide (CPM), doxorubicin (DXR), VCR, prednisolone, and rituximab [R-CHOP] and calculated RDI of each cytotoxic agent to analyze its influence on treatment outcome. The median RDI of CPM, doxorubicin, and VCR was 80.0, 81.7, and 78.4 %, respectively (p = 0.002). The average RDI (ARDI) of these three agents was 80.0 %. The overall survival was significantly worse in the low ARDI (<85 %) than in the high ARDI (>85 %) group (2-year survival rate 67.2 vs 93.4 %, p = 0.011). The survival rate with low RDI VCR (<85 %) was lower than that with high RDI VCR (>85 %), even when the remaining two agents had high ARDI (2-year survival rate 74.3 vs 95.8 %, p = 0.047). In conclusion, VCR dose tended to be reduced compared with CPM and DXR in R-CHOP. Lower ARDI of cytotoxic agents and lower RDI of VCR could lead to poor prognosis in the treatment of DLBCL with R-CHOP. We thought these observations should be confirmed in a prospective study. Keywords Diffuse large B cell lymphoma Chemotherapy Dose intensity R-CHOP Vincristine