3A Comparison between R-THP-COP and R-CHOP Regimens for the Treatment of Diffuse Large B-cell Lymphoma in Old Patients: A Single-institution Analysis
3A Comparison between R-THP-COP and R-CHOP Regimens for the Treatment of Diffuse Large B-cell Lymphoma in Old Patients: A Single-institution Analysis
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DOI：
10.2169/internalmedicine.8291-16
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发表时间：
2017-01-01
影响因子：
1.2
通讯作者：
Yamauchi, Takahiro
中科院分区：
文献类型：
--
作者：
Araie, Hiroaki;Sakamaki, Ippei;Yamauchi, Takahiro
目的回顾性比较利妥昔单抗（R）-THP-COP（吡拉托溴铵、环磷酰胺、长春新碱和泼尼松龙）与R-CHOP（利妥昔单抗、阿霉素、环磷酰胺、长春新碱和泼尼松龙）治疗老年弥漫性大B细胞淋巴瘤（DLBCL）的临床疗效和毒性反应。患者接受R（375 mg/m（2），第1天）-THP-COP（第1天吡拉罗肽50 mg/m2，第1天环磷酰胺750 mg/m2，第1天长春新碱1.4 mg/m2，第1-5天泼尼松龙100 mg）或R-CHOP（阿霉素50 mg/m2第1天，环磷酰胺750 mg/m2第1天，长春新碱1.4 mg/m2第1天，泼尼松龙100 mg第1-5天）。根据患者的年龄和相关并发症调整化疗药物的剂量。结果74例DLBCL患者（中位年龄65-90岁，男性39例，女性35例）中，R-THP-COP组29例，R-CHOP组45例。总有效率为94.6%（完全缓解86.4%，部分缓解8.1%）。R-THP-COP方案的2年总生存率和无进展生存率分别为77.6%和68.5%，R-CHOP方案为79.2%和78.9%。两种方案的临床疗效无显著性差异。最常见的不良事件是中性粒细胞减少（R-THP-COP方案为72.4%，R-CHOP方案为88.9%）。结论R-THP-COP是一种安全、有效的替代R-CHOP方案。
Objective We retrospectively compared the clinical efficacy and toxicity of rituximab (R)-THP-COP (pirarubicin, cyclophosphamide, vincristine, and prednisolone) with that of R-CHOP (rituximab, adriamicin, cyclophosphamide, vincristine, and prednisolone) in previously untreated old patients with diffuse large B-cell lymphoma (DLBCL).Patients and Methods Patients admitted to our institution between 2004 and 2013 were examined. The patients received either R(375 mg/m(2), day 1)-THP-COP (pirarubicin 50 mg/m(2) day 1, cyclophosphamide 750 mg/m(2) day 1, vincristine 1.4 mg/m2 day 1, and prednisolone 100 mg day 1-5) or R-CHOP (adriamicin 50 mg/m(2) day 1, cyclophosphamide 750 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, and prednisolone 100 mg day 1-5). The doses of chemotherapeutic agents were adjusted depending on the patient's age and associated complications. The treatment was performed for 6 to 8 cycles.Results Among 74 patients with DLBCL (median 76, range 65-90 years; male 39, female 35), 29 received R-THP-COP, while 45 received R-CHOP. The overall response rates were 94.6% (complete response 86.4%, partial response 8.1%). The 2-year overall and progression-free survival rates were 77.6% and 68.5% for the R-THP-COP regimen and 79.2% and 78.9% for R-CHOP, respectively. No significant differences were found between these two regimens regarding the clinical efficacies. The most frequent adverse event was neutropenia (72.4% for the R-THP-COP regimen, 88.9% for the R-CHOP regimen). The cardiac function as evaluated by ejection fraction values was not impaired in either regimen.Conclusion R-THP-COP was effective and safe as an alternative to R-CHOP.