Factors Associated with Early Termination of CHOP Therapy and the Impact on Survival among Patients with Chemosensitive Intermediate-Grade Non-Hodgkin's Lymphoma
2003; SAGE Publishing; Volume: 10; Issue: 5 Linguagem: Inglês
10.1177/107327480301000507
ISSN1526-2359
AutoresElizabeth A. Chrischilles, Brian K. Link, Shannon D. Scott, David J. Delgado, Moshe Fridman,
Tópico(s)Lung Cancer Treatments and Mutations
ResumoBackgroundSix to eight cycles of CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) is standard for intermediate-grade non-Hodgkin's lymphoma (NHL) but is associated with toxicity that may cause premature termination of therapy. MethodsWe studied factors associated with premature termination of CHOP therapy (receiving <6 cycles) and the relationship of premature termination with survival. Subjects consisted of a population-based sample of Iowa residents with intermediate-grade NHL who were planned to receive ≥6 cycles of CHOP and who were chemosensitive (ie, achieved a documented partial or complete response to CHOP). ResultsIn a comparison with patients 18-59 years of age, the odds of premature termination of CHOP therapy was 2.6 (95% CI, 0.7-9.2) for those aged 60-74 and 6.2 (95% CI, 1.7-23.3) for those aged ≥75. Patients with cycle 1 febrile neutropenia hospitalization (FNH) were 4.4 times (95% CI, 1.4-13.8) more likely to terminate CHOP prematurely than those without cycle 1 FNH. Among patients aged 60-74, but not those aged ≥75, premature termination appeared to be associated with decreased 5-year survival (hazard ratio [HR] = 6.0; 95% CI, 2.4-15.2) compared with those completing CHOP therapy (HR = 2.1; 95% CI, 1.0-4.2). Findings for overall survival were similar. ConclusionsFirst-cycle FNH and age ≥60 years were associated with premature termination of CHOP therapy. The association of premature termination with survival among chemosensitive patients differed by age.
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