Clinical Outcomes Of Induction Therapy With Addition Of High Dose Methotrexate And Cytarabine To Existing Standard Treatment In Patients With Newly Diagnosed Diffused Large B-Cell Lymphoma: A Retrospective Study

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Date
2018-07
Authors
Dang, Chee Chean
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Publisher
Universiti Sains Malaysia
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogenous group of diseases with various outcomes depending on the clinical and biological features. Optimal induction therapy for high-risk DLBCL is still unclear, and clinical trials are needed to evaluate alternative approaches. This study aimed to evaluate the response rates and long term remission of induction therapy with addition of high dose methotrexate and cytarabine onto RCHOP for patients diagnosed with DLBCL. 62 DLBCL patients diagnosed between January 2011 to December 2014 were retrospectively analyzed. Mean age at diagnosis for enrolled patients was 50 ± 13.4 years (range 18 – 77 years). A total of 38 patients received RCHOP/CHOP plus methotrexate or cytarabine or both (RCHOP/CHOP+MA/M/A) while 24 patients received only RCHOP/CHOP regimen. Kaplan-Meier method and log-rank test were used to analyze factors for univariate analysis. The complete remission (CR) rate was higher in the RCHOP/CHOP+MA/M/A arm (65.8%) compared to the RCHOP/CHOP arm (37.5%). There was a significant difference in overall survival (OS) comparing patients manifested with B symptoms and patients without B symptoms (p = 0.02). With respect to the initial response of frontline therapy, patients who achieved a complete remission (CR) was associated with significantly improved OS (p < 0.0001). Among 62 DLBCL patients who received ≥ 4 cycles chemotherapy, 2 (0.5%) experienced treatment-related mortality (TRM).
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Keywords
Clinical outcomes of induction therapy , with addition of high dose methotrexate
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