Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2014 May;165(4):489-96.
doi: 10.1111/bjh.12765. Epub 2014 Feb 7.

Comorbidity Is an Independent Prognostic Factor in Patients With Advanced-Stage Diffuse Large B-cell Lymphoma Treated With R-CHOP: A Population-Based Cohort Study

Affiliations
Observational Study

Comorbidity Is an Independent Prognostic Factor in Patients With Advanced-Stage Diffuse Large B-cell Lymphoma Treated With R-CHOP: A Population-Based Cohort Study

Andre Wieringa et al. Br J Haematol. .

Abstract

An observational population-based cohort study was performed to investigate the role of comorbidity on outcome and treatment-related toxicity in patients with newly diagnosed advanced-stage diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). Data for the clinical characteristics of 154 patients (median age 69 years), including Charlson Comorbidity Index (CCI), treatment, toxicity and outcome were evaluated. Forty-five percent of the patients had an International Prognistic index ≥3 and 16% had a CCI ≥2. The planned R-CHOP schedule was completed by 84% and 75% reached complete remission (CR). In those with CCI ≥2, 67% completed treatment with 46% CR. In patients with a CCI <2, overall survival (OS) after 1, 2 and 5 years was 84%, 79% and 65% respectively and it was 64%, 48% and 48% for those with CCI ≥2. Grade III/IV toxicity was documented in 53%, most frequently febrile neutropenia (27%) and infections (23%). In multivariate analysis CCI ≥2 and IPI ≥3 were independent risk indicators for OS and grade III/IV toxicity. In conclusion, comorbidity is an independent risk indicator for worse OS in patients with advanced DLBCL treated with R-CHOP by interference with intensive treatment schedules and more grade III/IV toxicity. Future studies are warranted to determine the optimal treatment approach in patients with significant comorbidities.

Keywords: R-CHOP; comorbidity; diffuse large B-cell lymphoma; population-based; toxicity.

Similar articles

See all similar articles

Cited by 16 articles

See all "Cited by" articles

Publication types

MeSH terms

Supplementary concepts

Feedback