Role of rituximab in the first-line therapy of high-risk diffuse large B-cell lymphoma: a retrospective analysis by the Polish Lymphoma Research Group

Jurczak, Wojciech; Ochrem, Bogdan; Giza, Agnieszka; Zimowska-Curyło, Dagmara; Górecki, Tomasz; Boguradzki, Piotr; Knopińska‐Posłuszny, Wanda; Stella‐Hołowiecka, Beata; Walewski, Jan; Joks, Monika; Wróbel, Tomasz; Zaucha, Jan Maciej

doi:10.20452/pamw.3113

Cited by 11 publications

(10 citation statements)

References 9 publications

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“…In our group, the clinical characteristics and risk factor distribution were representative of DLBCL and comparable to those described in the literature (Table ) . At the end of first‐line treatment, 150 (67.26%) patients achieved complete remission (CR), 62 (27.8%) partial remission (PR), 3 (1.3%) stable disease, and 7 (3.1%) progressive disease (PD).…”

Section: Resultsmentioning

confidence: 99%

The average relative dose intensity of R‐CHOP is an independent factor determining favorable overall survival in diffuse large B‐cell lymphoma patients

Długosz‐Danecka

Szmit²,

Ogórka

et al. 2019

Cancer Medicine

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The prognosis of diffuse large B‐cell lymphoma (DLBCL) patients depends on lymphoma‐ and patient‐related risk factors and is best estimated by the international prognostic index (IPI). The aim of the study was to determine whether the average relative dose intensity (ARDI) of an anthracycline‐containing regimen could predict DLBCL outcome independently from the IPI. We analyzed 223 white Caucasian DLBCL patients who completed at least four cycles of first‐line immunochemotherapy with rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R‐CHOP). The ARDI was calculated by specially developed software in each individual patient, simultaneously with the chemotherapy prescription, which instantly revealed all causes of its decrease. The relevance of the ARDI for progression‐free/overall survival (PFS/OS) was evaluated. Prolonged intervals between cycles of immunochemotherapy—the most common cause of decreased ARDI (49.3%, 110/223)—were due to neutropenia (absolute neutrophil count <1.0 × 109/L) and infections. Reductions in cytostatic doses were observed in 19.7% (44/223) of patients, mainly as the consequence of cardiotoxicity (23/223, 10.3%). The OS varied significantly when the ARDI was >90% (P < 0.00001). Multivariate analysis confirmed that an ARDI>90% was an IPI‐independent predictor of prolonged PFS (HR = 0.31; 95%CI: 0.20‐0.47; P < 0.00001) and OS (HR = 0.32; 95%CI: 0.21‐0.48; P < 0.00001). With an analytic tool allowing real‐time ARDI assessment, it was possible to maintain an ARDI above 90% in 161 of 223 patients (72%). DLBCL patients with an ARDI >90% have significantly better outcome regardless of the IPI; therefore, our official recommendation is an adequate dose density through efficient neutropenia prophylaxis and cardiac protection.

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Section: Resultsmentioning

confidence: 99%

The average relative dose intensity of R‐CHOP is an independent factor determining favorable overall survival in diffuse large B‐cell lymphoma patients

Długosz‐Danecka

Szmit²,

Ogórka

et al. 2019

Cancer Medicine

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“…Researches have shown that the new combined method provides a greater survival benefit for patients with DLBCL. [ 2 – 4 ] However, still>30% of DLBCL patients will become refractory to initial therapy or will relapse as a result. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of pretreatment neutrophil-lymphocyte ratio in patients with diffuse large B-cell lymphoma treated with RCHOP

Wang

Zhou

et al. 2016

Medicine

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This study aims to investigate whether neutrophil to lymphocyte ratio (NLR) is an independent predictor in newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients in the rituximab era. Data from newly diagnosed DLBCL patients at Nanjing Drum Tower Hospital from 2006 to 2015 were retrospectively reviewed. We used the receiver operating characteristic (ROC) curve analysis to generate the optimal cutoff value for NLR. Among those 156 patients enrolled, the NLR was < 3.0 in 46.8% (73/156) of the patients, and the remaining 53.2% (83/156) had an NLR ≥ 3.0. Patients with higher pretreatment NLR were found to correlate with poorer OS and PFS than these with lower NLR (hazard ratio [HR] = 2.66, 95% confidence interval [CI] = 1.43–4.97, P = 0.002 and HR = 1.79, 95% CI = 1.05–3.07, P = 0.034, respectively). The multivariate Cox proportional hazard model analysis further showed that high NLR was found independently predictive of poor OS (HR = 0.40; CI = 0.19–0.84, P = 0.015) and PFS (HR = 0.57; CI = 0.33–0.98, P = 0.042). Consequently, pretreatment NLR was an independent prognostic predictor in patients with DLBCL in the rituximab era.

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“…Herein, active treatment was in need, especially combination chemotherapy, such as combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP). The major advancement in the treatment of DLBCL was the addition of rituximab, a B cell depleting monoclonal anti-CD20-antibody, to CHOP, which indeed has provided a greater survival benefit in the treatment of DLBCL [2,3]. However, more than 30% of DLBCL will ultimately relapse [4].…”

Section: Introductionmentioning

confidence: 99%

Pretreatment C-reactive protein was an independent prognostic factor for patients with diffuse large B-cell lymphoma treated with RCHOP

Wang

Zhou

Wang

et al. 2016

Clinica Chimica Acta

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Role of rituximab in the first-line therapy of high-risk diffuse large B-cell lymphoma: a retrospective analysis by the Polish Lymphoma Research Group

Cited by 11 publications

References 9 publications

The average relative dose intensity of R‐CHOP is an independent factor determining favorable overall survival in diffuse large B‐cell lymphoma patients

The average relative dose intensity of R‐CHOP is an independent factor determining favorable overall survival in diffuse large B‐cell lymphoma patients

Prognostic role of pretreatment neutrophil-lymphocyte ratio in patients with diffuse large B-cell lymphoma treated with RCHOP

Pretreatment C-reactive protein was an independent prognostic factor for patients with diffuse large B-cell lymphoma treated with RCHOP

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