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. 2015;56(8):2365-72.
doi: 10.3109/10428194.2014.994206. Epub 2015 Feb 9.

Relationships between chemotherapy, chemotherapy dose intensity and outcomes of follicular lymphoma in the immunochemotherapy era: a report from the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource

Kitsada Wudhikarn  1 , Brian J Smith  2   3 , Anna M Button  2   3 , Thomas M Habermann  4 , Carrie A Thompson  4 , Lori J Rosenstein  1   3 , Sergei I Syrbu  5 , George J Weiner  1   3 , James R Cerhan  6 , Brian K Link  1   3
Affiliations

Relationships between chemotherapy, chemotherapy dose intensity and outcomes of follicular lymphoma in the immunochemotherapy era: a report from the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource

Kitsada Wudhikarn et al. Leuk Lymphoma. 2015.

Abstract

The optimal treatment of follicular lymphoma (FL) is not established. Rituximab's value potentially dilutes the impact of chemotherapy on FL. We reviewed 337 cases of FL treated initially with rituximab as monotherapy or with chemotherapy at the University of Iowa/Mayo Clinic from 2002 to 2009, investigating the association between chemotherapy delivery of cyclophosphamide or doxorubicin and survival. With median follow-up duration of 52.7 months, event-free survival (EFS) and overall survival (OS) were similar between the two groups, with a trend toward better EFS in the R-chemotherapy cohort (hazard ratio [HR]=1.24, p=0.28). In the R-chemotherapy group, increased total dose delivery and delivered dose intensity of doxorubicin were associated with improved EFS only in patients who did not receive R-maintenance (HR=0.81; p=0.02 and HR=0.94; p=0.04). Cyclophosphamide delivery was not associated with EFS. Thus, in the immunochemotherapy era, chemotherapy delivery strategy requires re-evaluation.

Keywords: Follicular lymphoma; dose intensity; immunochemotherapy; treatment delivery.

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Figures

Figure I
Figure I
Distribution of chemotherapy delivered dose intensity (DDI) and total dose delivery (TDD)
Figure I
Figure I
Distribution of chemotherapy delivered dose intensity (DDI) and total dose delivery (TDD)
Figure II
Figure II
Kaplan Meier survival curve of R-monotherapy treated patients and R-chemotherapy treated patients
See this image and copyright information in PMC

References

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