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Comparison Between CHOP and DAEPOCH with or Without Rituximab in Adult High Grade B Cell Lymphoma, Not Otherwise Specified; A Retrospective Study From a Tertiary Cancer Hospital in South India
Indian Journal of Hematology and Blood Transfusion ( IF 0.7 ) Pub Date : 2021-04-02 , DOI: 10.1007/s12288-021-01427-8
Lalatendu Moharana 1 , Lokanatha Dasappa 1 , Suresh Babu 1 , K N Lokesh 1 , Ah Rudresh 1 , L K Rajeev 1 , Smitha Saldanha 1 , Kanika Sharma 1 , Linu Abraham Jacob 1
Affiliation  

Lymphoma that on morphology appear blastoid or intermediate between DLBCL and BL but who lack myc and bcl-2 and/or bcl-6 rearrangements are grouped under high grade B-cell lymphoma, not otherwise specified (HGBL, NOS). Only a few studies have yet compared the outcome of HGBL, NOS treated with different chemo-immunotherapy regimens. HGBL, NOS patients were analyzed retrospectively, who were treated with CHOP or DAEPOCH regimens every 21 days for six cycles with or without rituximab. The primary clinical objective was progression free survival. One and two year PFS rates were 29.4% and 20.6% for the CHOP arm and, 65.2% and 47.8% for the DAEPOCH arm respectively. There was statistically significant difference in mean PFS between the arms (DAEPOCH vs CHOP: 19.7 months vs 12.8 months; HR = 0.44, p = 0.02, 95% CI: 0.22–0.88). One and two year OS rates were 91.1% and 20.5% for the CHOP arm and 95.6% and 60.8% for the DAEPOCH arm respectively. Mean OS was significantly better for DAEPOCH arm (28.1 months vs 20.7 months: HR = 0.43, p = 0.03, 95% CI: 0.20–0.92). Grade 3 and 4 hematological and non-hematological toxicities were more common in DAEPOCH arm. There were 2 treatment related deaths, 1 in each arm (4.3% for DAEPOCH vs 2.9% for CHOP). HGBL, NOS is a heterogeneous group of aggressive lymphoma associated with early relapse in nearly half of the cases. Intensive regimens like DAEPOCH is associated with improved outcome in terms of PFS and OS. Though toxicities are more with DAEPOCH, they are manageable and treatment related mortality is low.



中文翻译:

CHOP 和 DAEPOCH 联合或不联合利妥昔单抗治疗成人高级别 B 细胞淋巴瘤的比较,未另行说明;来自印度南部一家三级肿瘤医院的回顾性研究

在形态学上表现为母细胞样或介于 DLBCL 和 BL 之间但缺乏 myc 和 bcl-2 和/或 bcl-6 重排的淋巴瘤被归类为高级 B 细胞淋巴瘤,未另行说明(HGBL,NOS)。只有少数研究比较了 HGBL、NOS 用不同化学免疫疗法治疗的结果。对 HGBL、NOS 患者进行回顾性分析,这些患者接受 CHOP 或 DAEPOCH 方案治疗,每 21 天一次,持续六个周期,有或没有利妥昔单抗。主要临床目标是无进展生存期。CHOP 组的一年和两年 PFS 率分别为 29.4% 和 20.6%,DAEPOCH 组分别为 65.2% 和 47.8%。两组间的平均 PFS 存在统计学显着差异(DAEPOCH 与 CHOP:19.7 个月与 12.8 个月;HR = 0.44,p = 0.02,95% CI:0.22–0.88)。CHOP 组的一年和两年 OS 率分别为 91.1% 和 20.5%,DAEPOCH 组分别为 95.6% 和 60.8%。DAEPOCH 组的平均 OS 明显更好(28.1 个月与 20.7 个月:HR = 0.43,p  = 0.03,95% CI:0.20–0.92)。3 级和 4 级血液学和非血液学毒性在 DAEPOCH 组中更为常见。有 2 例治疗相关死亡,每组 1 例(DAEPOCH 为 4.3%,CHOP 为 2.9%)。HGBL、NOS 是一组异质性侵袭性淋巴瘤,近半数病例早期复发。像 DAEPOCH 这样的强化方案与 PFS 和 OS 方面的改善结果相关。尽管 DAEPOCH 的毒性更大,但它们是可控的,并且与治疗相关的死亡率很低。

更新日期:2021-04-02
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