Impact of Anthracycline Dose in Elderly Patients with Difusse Large B Cell Lymphoma (DLBCL) at the Instituto Nacional De Cancerologia Mexico

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AudienciaPúblico en generales_ES
CoberturaMéxicoes_ES
Fecha de ingreso2026-09-15T00:31:43Z
Fecha de publicación2015-12-03
ResumenAbstract Background: Lymphoproliferative disorders have increased in last decades. The value of the cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) plus rituximab (R-CHOP) combination therapy in both aggressive and indolent B-cell lymphoma has been demonstrated in several clinical trials. Treatment of patients > 65 years remains controversial and chemotherapy dose has been decreased due to comorbities, particularly cardiac insuficiency Methods: Retrospective, comparative, non randomized study. Inclussion criteria: > 65 years patients with hystologically diagnosis of DLBCL, treated in a single national reference, from January 2011 until January 2015. Demographic characteristics, comorbidities were analyzed. Three regimens of treatment (RCHOP , RChOP & RCOP, see doses in table) were compared in terms of response, efficacy and survival. Descriptive analysis was done fore demographic & clinical characteristics. Suvival was calculated with Kaplan-Meier method Log rank test analysis was done to compare DFS & OS, stratifed by treatment regimen. Results: 141 cases, with a median age of 74.15 y (range 65- 96 y), None difference was found among the 3 treatment regimens for the following variables: Comorbities are detailed by treatment group in the following table. (25 % Diabetes mellitus, 29 % blood hypertension), B symptoms (70 %), clinical stage III- IV ( 68 %), most had an adequate ECOG (1-2: 90 %), and most were considere as high-intermediate or high risk (68 %) according with R-IPI scale. However, only a higher proportion of patients with GC subtype was documented in RCHOP patients (54.7 % vs 35 % and 27.1% in RChOP & RCOP groups, respectively. Global response (CR + PR) was achieved in 77.3 %, 60 % & 68.8 % in patients treated with RCHOP, RChop & RCOP, respectively. The following table describes toxicities by treatment regimen. DFS (but not OS) and OS was better in patients with RCHOP. Table. RCHOP RChoP RCOP P Doses 375 mg/m² RTX, 750 mg/m² CFM, 50 mg/m² DOXO, 1.4 mg VCR ,100 mg daily x 5 PDN 375 mg/m² RTX, 750 mg/m² CFM, 25 mg/m² DOXO, 1.4 mg VCR ,100 mg daily x 5 PDN 375 mg/m² RTX, 750 mg/m² CFM, 1.4 mg VCR ,100 mg daily x 5 PDN -- N (%) 53 (100) 48 (100) 40 (100) -- Blood arterial hypertention 26.4 % 27.1 % 35 % 0.62 Diabetes mellitus 11.3 % 25 % 32.5 % 0.042 DiabeteR-IPI (3-4) 58.5 % 60.4 % 65 % 0.85 Complications of treatment: Infections None/ambulatory/hospitalization 18/15/8 14/12/1112 23/10/43 0.090 MyelosupressionNone/none without transfusion required/ required transfusion 36/6/11 30/8/10 26/5/9 0.948 Other complication (G III-IV):None Cardiovascular Renal Gastrointestinal Neuropathy Thrombosis - 28 8 4 8 1 1 - 17 5 7 5 5 3 - 24 4 2 6 2 0 0.359 Disease free survival Median (P25-P75) -33.26 (25.43-39.10) 26.13(19.85-30.33) 36.16 (26.76-37.83) 0.011 Overall survival Media (95 % Confidence interval) 37.7 (32.7-42.7)) 29.44 (23.60-35.28) 27.09 (20.81-33.37) 0.135 Conclussion: The group of patients treated with RChOP & RCOP had a worse DFS and but not OS, which may be influenced by a either higher proportion of patients with non-GC subtype, or reduction of anthracycline dose. Although regimens with chemotherapy dose reductions (mini-RCHOP) have been accepted for these patients, an individual evaluation is recommended in this population. Disclosures No relevant conflicts of interest to declare.es_ES
Doihttps://doi.org/10.1182/blood.v126.23.5066.5066es_ES
URIhttps://riuat.uat.edu.mx/handle/123456789/3428
Idiomaenes_ES
EditorialElsevier BVes_ES
RelaciónBloodes_ES
URL relacionadohttps://doi.org/10.1182/blood.v126.23.5066.5066es_ES
DerechosAcceso restringido / Suscripción (Metadatos de producción científica)es_ES
Licenciahttp://purl.org/coar/access_right/c_16eces_ES
FuenteBlood
Palabra claveMedicinees_ES
Palabra claveInternal medicinees_ES
Palabra claveVincristinees_ES
Palabra claveAnthracyclinees_ES
Palabra clavePrednisonees_ES
Palabra claveRituximabes_ES
Palabra claveDiffuse large B-cell lymphomaes_ES
Palabra claveRegimenes_ES
Palabra claveCyclophosphamidees_ES
Palabra claveGastroenterologyes_ES
Palabra claveAggressive lymphomaes_ES
Palabra claveChemotherapy regimenes_ES
ClasificaciónLymphoma Diagnosis and Treatmentes_ES
TítuloImpact of Anthracycline Dose in Elderly Patients with Difusse Large B Cell Lymphoma (DLBCL) at the Instituto Nacional De Cancerologia Mexicoes_ES
TipoArtículoes_ES
ArbitradoHa sido Arbitradoes_ES
Autor-Medina, Diana Nolasco
AutorAlejandro, Mohar
AutorReynoso‐Noverón, Nancy
AutorAvilés‐Salas, Alejandro
AutorGarcía-Mata, Osvaldo
AutorCandelaria, Myrna
Autor-Medina, Diana Nolascoes_ES
AutorAlejandro, Mohares_ES
AutorReynoso‐Noverón, Nancyes_ES
AutorAvilés‐Salas, Alejandroes_ES
AutorGarcía-Mata, Osvaldoes_ES
AutorCandelaria, Myrnaes_ES
InstituciónUniversidad Autónoma de Tamaulipas
InstituciónUniversidad Autónoma de Tamaulipases_ES
Número23es_ES
Rango de páginas5066-5066es_ES
URL relacionadahttps://doi.org/10.1182/blood.v126.23.5066.5066
Tipo de artículoIndexado
Tipo de artículoIndexadoes_ES
Volumen126es_ES

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