Abstract
Abstract 1626
Diffuse large B cell lymphoma (DLBCL) is one of the most common types of non-Hodgkin's lymphoma. R-CHOP21 (C21) is considered the standard therapy but a large number of studies tested R-CHOP14 (C14).
The aim of our study was to evaluate retrospectively a cohort of patients (pts) treated with C21 or C14.
All pts with diagnosis of DLBCL or follicular grade IIIb lymphoma, treated with curative intent were accrued.
From January 2002 to December 2010, 123 pts were treated with C21 and 142 were treated with C14. The median age was 63 (range 19–89). The two cohorts of pts were balanced for all clinical characteristics a part for age (<65 or >64 years) with more aged pts in C21 arm (p 0.000), PS with more advanced PS (2–3) in C21 arm (0.000) and LDH value which was more frequently elevated in C14 arm (p: 0.002). After induction therapy 190 pts (71%) obtained a complete remission: 82/123 (67%) after C21 and 108/142 (75%) after C14. After a median period of observation of 31 months 81 pts relapsed, 42 (51%) in the C21 arm and 39 (36%) in the C14 arm. Considering the two therapies, C21 vs C14, no differences were reported in OS, PFS and DFS: 61% vs 68%, 59% vs 58% and 74% vs 61% respectively. In univariate analysis OS was lower in older pts (p: 0.02), advanced stage (p: 0.02), symptomatic disease (p: 0.05), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.02) and intermediate or high risk IPI (p: 0.000); PFS was lower in advanced stage (p: 0.002), symptomatic disease (p: 0.009), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.001) and intermediate high risk IPI (p: 0.000). In multivariate analysis OS was significantly better in low-intermediate IPI risk pts (p: 0.000) and in pts treated with C14 (p: 0.02); the PFS was better in low-intermediate IPI risk pts (p: 0.000). Considering only pts with low or low-intermediate IPI we observed that OS was significantly superior in the group treated with C14 (90% vs 64% p: 0.03), moreover in young pts (< 65 years) OS was better in pts treated with C14 (81% vs 58% p: 0.05). As expected hematological grade III/IV toxicity was more frequent in pts treated with C14, all pts but three (2%) completed the therapy without delay or dose reduction. No differences in extra-hematological toxicity were observed.
Conclusions:
In conclusion our results confirm that C14 do not improve the results of the standard C21 in the whole lymphoma population but in a subset of pts, young and low/intermediate risk pts, the C14 scheme seems to improve the OS. We will enlarge the cohort of studied patients but further prospective randomized studies are needed to verify this preliminary observations.
Disclosures:
No relevant conflicts of interest to declare.
Prognostic significance of bone marrow infiltration detected by PET-CT in newly diagnosed diffuse large B cell lymphoma