Importance of maintaining the relative dose intensity of CHOP-like regimens combined with rituximab in patients with diffuse large B-cell lymphoma
Importance of maintaining the relative dose intensity of CHOP-like regimens combined with rituximab in patients with diffuse large B-cell lymphoma
复制标题
DOI：
10.1007/s00277-010-0956-7
复制
发表时间：
2010-09-01
影响因子：
3.5
通讯作者：
Dan, Kazuo
中科院分区：
文献类型：
--
作者：
Hirakawa, Tsuneaki;Yamaguchi, Hiroki;Dan, Kazuo
CHOP类方案联合利妥昔单抗是治疗弥漫性大B细胞淋巴瘤（DLBCL）的标准化疗方案。建议用相对剂量强度（RDI）作为药物剂量和给药间隔的指标。既往研究报告，CHOP治疗期间维持RDI可改善治疗结果。然而，很少有关于RDI的研究回顾了接受CHOP和利妥昔单抗联合治疗的患者。我们研究了RDI维持治疗（包括与利妥昔单抗联合治疗）对DLBCL患者治疗效果的影响。我们回顾性分析了152例接受CHOP类方案联合利妥昔单抗治疗的DLBCL患者，其中RDI可以随访。多因素分析显示，国际预后指数（IPI）高中-高（HI-H）（p = 0.005）和RDI小于70%（p = 0.007）是低进展无生存期的独立预后因素。关于总生存率，IPI HI-H（p = 0.027）和RDI小于70%（p = 0.002）与预后不良有关。此外，年龄超过60岁（p = 0.003）、R-THPCOP（p = 0.034）或存在发热性中性粒细胞减少症（p = 0.004）使RDI维持困难，预防性G-CSF治疗（p = 0.026）对维持RDI有用。即使在利妥昔单抗联合化疗治疗DLBCL的时代，维持RDI也很重要。
CHOP-like regimen combined with rituximab is a standard chemotherapy for diffuse large B-cell lymphoma (DLBCL). The relative dose intensity (RDI) was proposed as an index of the dose and administration interval of agents. Previous studies reported that the maintenance of the RDI during CHOP therapy improved the treatment results. However, few studies regarding RDI have reviewed patients receiving combination therapy with CHOP and rituximab. We investigated the influence of RDI maintenance, involving combination therapy with rituximab, on therapeutic effects in patients with DLBCL. We retrospectively examined 152 DLBCL patients who were treated with CHOP-like regimen combined with rituximab in whom the RDI could be followed up. Multivariate analysis revealed that international prognosis index (IPI) high intermediate-high (HI-H) (p = 0.005) and RDI of less than 70% (p = 0.007) were independent prognostic factors for low progression free survival. Concerning overall survival, IPI HI-H (p = 0.027) and an RDI of less than 70% (p = 0.002) were involved in an unfavorable prognosis. In addition, age over 60 years (p = 0.003), R-THPCOP (p = 0.034), or the presence of febrile neutropenia (p = 0.004) made RDI maintenance difficult, and prophylactic G-CSF therapy (p = 0.026) was useful for maintaining the RDI. Maintaining the RDI is important even in the era of rituximab-combined chemotherapy for DLBCL.