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- Title
R-CHOEP14 in younger high-risk patients with large B cell lymphoma: an effective front-line regimen with cardiac toxicity: a real-life, single-center experience.
- Authors
Bašić-Kinda, Sandra; Radman, Ivo; Dujmović, Dino; Ilić, Ivana; Kralik, Marko; Dobrenić, Margareta; Galunić-Bilić, Lea; Rončević, Pavle; Vodanović, Marijo; Sertić, Zrinka; Hude, Ida; Aurer, Igor
- Abstract
Currently, there is no consensus regarding optimal front-line treatment for younger high-risk patients with large B cell lymphoma. American recommendations list only R-CHOP as standard, while European also include R-ACVBP and R-CHOEP14. We have been routinely using the latter regimen at our institution since 2011 and performed this retrospective real-life single-center study to analyze outcomes. Between September 2011 and April 2019, 66 newly diagnosed patients aged 18 to 60 years with B-large cell lymphoma and high-risk age-adjusted International Prognostic Index score were scheduled to receive 6 or 8 cycles of bi-weekly chemoimmunotherapy with cyclophosphamide, doxorubicin, vincristine, etoposide, steroids, and rituximab (R-CHOEP14). After a median follow-up of 4.7 years, the estimated 3-year progression-free survival was 87% (95% CI 80-96%) and 3-year overall survival 90% (95% CI 83-98%). Grade ≥ 3 hematological side effects occurred in 83% and infectious in 41% of patients; one patient died of toxicity. Grade ≥ 2 cardiac toxicity occurred in 21% of patients, more frequently than previously reported. The cumulative 5-year risk of congestive heart failure with all-cause mortality as the competing risk was 17%. R-CHOEP14 is a very effective and manageable regimen for younger high-risk patients with B-large cell lymphoma, but the risk of cardiotoxicity warrants further investigations.
- Subjects
B cell lymphoma; CARDIOTOXICITY; OVERALL survival; CONGESTIVE heart failure; MORTALITY; THERAPEUTIC use of antineoplastic agents; STEROID drugs; ETOPOSIDE; STEROIDS; DOXORUBICIN; RETROSPECTIVE studies; ANTINEOPLASTIC agents; TREATMENT effectiveness; CYCLOPHOSPHAMIDE; RESEARCH funding; VINCRISTINE; LONGITUDINAL method
- Publication
Annals of Hematology, 2021, Vol 100, Issue 6, p1517
- ISSN
0939-5555
- Publication type
journal article
- DOI
10.1007/s00277-020-04353-3