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. 2016 May 27:22:1792-800.
doi: 10.12659/msm.895383.

High-Intensity Chemotherapy is Associated with Better Prognosis in Young Patients with High-Risk Diffuse Large B-Cell Lymphoma: A 10-Year Single-Center Retrospective Cohort Study

Xiaorong Ma  1 , Yan Xu  1 , Wanggang Zhang  1 , Jin Wang  1 , Xingmei Cao  1 , Yinxia Chen  1 , Aili He  1 , Jie Liu  1 , Jianli Wang  1 , Wanhong Zhao  2 , Yun Yang  2
Affiliations

High-Intensity Chemotherapy is Associated with Better Prognosis in Young Patients with High-Risk Diffuse Large B-Cell Lymphoma: A 10-Year Single-Center Retrospective Cohort Study

Xiaorong Ma et al. Med Sci Monit. .

Abstract

BACKGROUND Patients <60 years old with high-risk diffuse large B-cell lymphoma (DLBCL) receiving standard RCHOP(E) treatment display high relapse rates. Here, we compared this standard regimen to a high-intensity regimen in terms of recurrence and long-term survival. MATERIAL AND METHODS Newly diagnosed DLBCL patients <60 years old who were treated at the Second Hospital Affiliated with Xi'an Jiaotong University between January 2004 and December 2013 (n=198, 18-60 years) were included in the study. The high-intensity group included 107 patients (54.0%) who received >8 courses of chemotherapy (high-dose CHOP, CHOP-E, EPOCH, MAED, MMED, and HyperCVAD). The control group included 91 patients (46.0%) who received 6-8 courses of CHOP-based treatment. Response rate (RR), survival, relapse, and adverse effects were compared. RESULTS Baseline characteristics of the patients were similar between the 2 groups. Median follow-up was 64.5 months. RR in the high-intensity and control groups was 88.8% and 84.6% (P=0.387), respectively; 5-year overall survival was 66.4% and 36.3% (P<0.001), respectively; 5-year progression-free survival was 56.1% and 28.6% (P<0.001), respectively; 5-year disease-free survival was 54.2% and 24.2% (P<0.001), respectively; and relapse rate during follow-up was 29.5% and 67.5% (P<0.001), respectively. There were no significant differences in adverse effects between the 2 groups. CONCLUSIONS High-intensity chemotherapy is associated with better prognosis of patients <60 years old with newly diagnosed high-risk DLBCL.

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Figures

Figure 1
Figure 1
Survival of the control and high-intensity groups. (A) Overall survival. (B) Progression-free survival. (C) Disease-free survival.
Figure 2
Figure 2
Survival according to rituximab combination. (A) Overall survival. (B) Progression-free survival. (C) Disease-free survival.
Figure 3
Figure 3
Survival according to GCB and Non-GCB subtypes and to rituximab combination. (A) Overall survival. (B) Progression-free survival. (C) Disease-free survival.
See this image and copyright information in PMC

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