Study Compares the Effectiveness of Treatments for Diffuse Large B-Cell Lymphoma

Patients with limited stage diffuse large B-cell lymphoma tolerated treatment with an abbreviated chemotherapy course plus radiation more easily than a full course of chemotherapy alone, according to a study andabstract published online August 6 in the journal Leukemia & Lymphoma. Researchers analyzed patient records from the Surveillance, Epidemiology and End Results-Medicare database and the Dana-Farber Lymphoma Clinical Research Information System. They found that while both treatments resulted in similar overall survival rates, abbreviated chemotherapy with radiation was associated with a lower risk of retreatment, fever and neutropenia (a reduction in white blood cells).

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2014 Aug 6:1-9. [Epub ahead of print]

Limited stage diffuse large B-cell lymphoma: comparative effectiveness of treatment strategies in a large cohortof elderly patients.

Odejide OO1, Cronin AM, Davidoff AJ, LaCasce AS, Abel GA.

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Abstract

Optimal treatment for limited stage diffuse large B-cell lymphoma (DLBCL) in the elderly is controversial. Using the Surveillance, Epidemiology and End Results-Medicare database, we compared overall survival (OS), time to second-line therapy (surrogate for recurrence) and adverse events inelderly patients diagnosed with stage I or II DLBCL in 1999-2009, who received either abbreviated rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (RCHOP) plus radiation or 6-8 cycles of RCHOP alone. Of 874 patients, 359 received abbreviated RCHOP with radiation, and 515 received a full course of RCHOP. In propensity score-adjusted analyses, OS was similar in both groups (hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.76, 1.38). Abbreviated RCHOP with radiation was associated with lower risk of second-line therapy (HR 0.71, 95% CI 0.53, 0.94) and lower odds of febrile neutropenia (odds ratio [OR] 0.27, 95% CI 0.15, 0.50). While the two treatments resulted in similar survival, our data suggest that abbreviated RCHOP with radiation may be better tolerated than a full course of RCHOP.