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Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma. The standard therapy for DLBCL is R-CHOP. The current 5-year overall survival (OS) is 60-70% using standard frontline therapy. However, the use of doxorubicin and its cardiotoxicity is a major clinical problem and pre-exiting cardiac disease may prevent the use of doxorubicin. Age greater than 65 years is a significant risk factor for anthracycline-induced cardiotoxicity and therefore the use of R-CHOP is often withheld from elderly patients. The feasibility of replacing doxorubicin with either epirubicin or etoposide in patients who have risk factors for heart complications is analysed here. Clinical data of 223 DLBCL patients was retrospectively collected from hospital records. Fifty-five patients were treated with R-CHOP, 105 with R-CIOP (epirubicin instead of doxorubicin), 17 with R-CEOP (etoposide instead of doxorubicin) and 31 with R-CHOEP. Matched-pair analysis was carried out between 30 patients treated with R-CEOP and R-CHOP. For all patients, the 2-year PFS was 73.6 %. In patients treated with R-CHOP, the 2-year PFS was 84.2 %, with R-CIOP 64.4 %, with R-CEOP 87.7 % and with R-CHOEP 83.2 %. In matched-pair analysis, the 2-year PFS was 92.3 % with R-CHOP and 86.2 % with R-CEOP. The 2-year DSS was 100 % with R-CHOP and 86.2 % with R-CEOP. In conclusion, R-CEOP offers reasonable PFS and DSS in the treatment of DLBCL and good disease control can be achieved in elderly patients. Elderly patients with impaired cardiac function could benefit from the use of R-CEOP instead of R-CHOP. The results with R-CIOP were unsatisfactory and we do not recommend using this protocol in elderly patients with cardiac disease.
This article was published in the following journal.
Name: Hematological oncology
Comorbidity impacts overall survival among patients with diffuse large B-cell lymphoma (DLBCL). However, associations of comorbidity with lymphoma characteristics, treatment selection and lymphoma-spe...
In older patients lymphoma is a frequent disease and diffuse large B-cell lymphoma (DLBCL) represents >60% of all lymphomas. Elderly patients with DLBCL are a heterogeneous population and the definiti...
The study objective was to compare the prognostic value of interim and end-of-treatment FDG PET/CT using five therapeutic evaluation criteria in patients with diffuse large B cell lymphoma (DLBCL).
To investigate the clinical outcome of the patients with primary diffuse large B-cell lymphoma（DLBCL）.
Despite effective therapies, outcomes for diffuse large B-cell lymphoma (DLCBL) remain heterogeneous in older individuals due to comorbid diseases and variations in disease biology.
The purpose of this study is to investigate efficacy and safety of R-GemOx Versus R-miniCHOP as first-line treatment of elderly patients with Diffuse large B cell lymphoma
To explore the clinical features and efficacy evaluation of large b-cell lymphoma in old age.
The purpose of the study is to evaluate efficacy and safety of R-miniCHOP for elderly patients with diffuse large B-Cell lymphoma (DLBC) Lymphoma aged over 80 years by measuring the overal...
GA101-miniCHOP regimen for the treatment of elderly unfit patients with diffuse large B-cell non-Hodgkin's lymphoma.
This study will validate the impact of comprehensive geriatric assessments using activity of daily living (ADL), instrumental activity of daily living (IADL), and Charlson's comorbidity in...
B-cell lymphoid tumors that occur in association with AIDS. Patients often present with an advanced stage of disease and highly malignant subtypes including BURKITT LYMPHOMA; IMMUNOBLASTIC LARGE-CELL LYMPHOMA; PRIMARY EFFUSION LYMPHOMA; and DIFFUSE, LARGE B-CELL, LYMPHOMA. The tumors are often disseminated in unusual extranodal sites and chromosomal abnormalities are frequently present. It is likely that polyclonal B-cell lymphoproliferation in AIDS is a complex result of EBV infection, HIV antigenic stimulation, and T-cell-dependent HIV activation.
Malignant lymphoma composed of large B lymphoid cells whose nuclear size can exceed normal macrophage nuclei, or more than twice the size of a normal lymphocyte. The pattern is predominantly diffuse. Most of these lymphomas represent the malignant counterpart of B-lymphocytes at midstage in the process of differentiation.
A group of malignant lymphomas thought to derive from peripheral T-lymphocytes in lymph nodes and other nonlymphoid sites. They include a broad spectrum of lymphocyte morphology, but in all instances express T-cell markers admixed with epithelioid histiocytes, plasma cells, and eosinophils. Although markedly similar to large-cell immunoblastic lymphoma (LYMPHOMA, LARGE-CELL, IMMUNOBLASTIC), this group's unique features warrant separate treatment.
A human cell line established from a diffuse histiocytic lymphoma (HISTIOCYTIC LYMPHOMA, DIFFUSE) and displaying many monocytic characteristics. It serves as an in vitro model for MONOCYTE and MACROPHAGE differentiation.
A systemic, large-cell, non-Hodgkin, malignant lymphoma characterized by cells with pleomorphic appearance and expressing the CD30 ANTIGEN. These so-called "hallmark" cells have lobulated and indented nuclei. This lymphoma is often mistaken for metastatic carcinoma and MALIGNANT HISTIOCYTOSIS.