1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
3Department of Pathology, Seoul National University Hospital Seoul, Korea
Copyright © 2016 by the Korean Cancer Association
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p-value for 2-year PFS rate: (a+b) vs. (c+d+e+f)=0.036; (a) vs. (b)=0.271; (c) vs. (d)=0.362; (c) vs. (e)=0.462; (c) vs. (f)=0.392; (d) vs. (e)=0.782; (d) vs. (f)=0.913; (e) vs. (f)=0.815. p-value for 2-year OS rate: (a+b) vs. (c+d+e+f)=0.031; (a) vs. (b)=0.174; (c) vs. (d)=0.216; (c) vs. (e)=0.577; (c) vs. (f)=0.859; (d) vs. (e)=0.065; (d) vs. (f)=0.103; (e) vs. (f)=0.637. DID, dose intensity of doxorubicin; DLBCL, diffuse large B cell lymphoma; PFS, progression-free survival; OS, overall survival.
Cause | DID ≤ 10 mg/m2/wk | DID > 10 mg/m2/wk |
---|---|---|
Treatment related mortality | 4 (50.0) | 11 (28.9) |
Disease progression | 3 (37.5) | 14 (36.8) |
Unknown | 1 (12.5) | 9 (23.7) |
Secondary malignancy | 0 | 4 (10.5) |
Characteristic | No. of patients (%) | Age < 70 yr | Age ≥ 70 yr | p-value |
---|---|---|---|---|
Age | ||||
No. (%) | 433 | 350 (80.8) | 83 (19.2) | |
Median (range) | 58 (16-91) | 54 (16-69) | 74 (70-90) | |
B Symptoms | ||||
No | 327 (75.5) | 265 (75.7) | 62 (74.7) | 0.847 |
Yes | 106 (24.5) | 85 (24.4) | 21 (25.3) | |
Ann Arbor stage | ||||
I/II | 233 (53.8) | 192 (54.9) | 41 (49.4) | 0.370 |
III/IV | 200 (46.2) | 158 (45.1) | 42 (50.6) | |
Performance status | ||||
ECOG 0-1 | 357 (82.4) | 303 (86.6) | 54 (65.1) | < 0.001 |
ECOG 2 or more | 76 (17.6) | 47 (13.4) | 29 (34.9) | |
LDH level | ||||
Normal | 179 (41.3) | 148 (42.5) | 31 (37.3) | 0.390 |
Elevated | 252 (58.2) | 200 (57.5) | 52 (62.7) | |
No. of extranodal sites | ||||
0-1 | 222 (51.3) | 181 (51.7) | 41 (49.4) | 0.704 |
2 or more | 211 (48.7) | 169 (48.3) | 42 (50.6) | |
IPI score | ||||
0-1 | 208 (48.0) | 184 (52.6) | 24 (28.9) | < 0.001 |
2 | 105 (24.2) | 83 (23.7) | 22 (26.5) | |
3 | 71 (16.4) | 53 (15.1) | 18 (21.7) | |
4-5 | 49 (11.3) | 30 (8.6) | 19 (22.9) | |
Bone marrow involvement | ||||
Absence | 355 (82.0) | 295 (86.0) | 60 (76.9) | 0.046 |
Presence | 66 (15.2) | 48 (14.0) | 18 (23.1) | |
Bulky disease | ||||
No | 340 (78.5) | 274 (78.3) | 66 (79.5) | 0.806 |
Yes | 93 (21.5) | 76 (21.8) | 17 (20.5) |
DID (mg/m2/wk) | No. of patients subgroup (%) |
2-Year PFS/OS rate (%) according to DID subgroup in aged ≥ 70 yr |
||
---|---|---|---|---|
Age < 70 yr | Age ≥ 70 yr | 2-Year PFS rate | 2-Year OS rate | |
(a) 6.7 < DID ≤ 8.3 | 5 (1.4) | 5 (6.0) | 30.0 | 20.0 |
(b) 8.3 < DID ≤ 10.0 | 3 (0.9) | 5 (6.0) | 40.0 | 60.0 |
(c) 10.0 < DID ≤ 11.7 | 6 (1.7) | 8 (9.6) | 85.7 | 75.0 |
(d) 11.7 < DID ≤ 13.4 | 33 (9.5) | 35 (42.2) | 61.1 | 50.4 |
(e) 13.4 < DID ≤ 15.0 | 36 (10.3) | 9 (10.8) | 66.7 | 88.9 |
(f) 15.0 < DID ≤ 16.7 | 266 (76.2) | 21 (25.3) | 63.8 | 66.7 |
Clinical outcome | Dose intensity of doxorubicin (mg/m2/wk) |
|||||
---|---|---|---|---|---|---|
Age < 70 yr |
Age ≥ 70 yr |
|||||
≤ 10 | > 10 | p-value | ≤ 10 | > 10 | p-value | |
Attainment of CR | ||||||
No | 4 (44.4) | 59 (17.3) | 0.059 | 4 (40.0) | 26 (35.6) | 1.000 |
Yes | 5 (55.6) | 282 (82.7) | 6 (60.0) | 47 (64.4) | ||
Disease progression | ||||||
No | 3 (33.3) | 268 (78.6) | 0.005 | 4 (40.0) | 48 (65.8) | 0.164 |
Yes | 6 (66.7) | 73 (21.4) | 6 (60.0) | 25 (34.2) | ||
Death | ||||||
No | 4 (44.4) | 272 (79.8) | 0.023 | 2 (20.0) | 35 (47.9) | 0.173 |
Yes | 5 (55.6) | 69 (20.2) | 8 (80.0) | 38 (52.1) | ||
2-Year PFS rate (%) | 55.6 | 82.0 | < 0.001 | 35.0 | 65.7 | 0.036 |
HR for PFS (95% CI) | 4.043 (1.756-9.305) | 0.001 | 2.520 (1.021-6.224) | 0.045 | ||
2-Year OS rate (%) | 66.7 | 84.7 | 0.004 | 40.0 | 62.6 | 0.031 |
HR for OS (95% CI) | 3.459 (1.394-8.579) | 0.007 | 2.242 (1.036-4.854) | 0.040 |
Variable | Multivariate |
Univariate |
||||
---|---|---|---|---|---|---|
HR | 95% CI | p-value | HR | 95% CI | p-value | |
B Symptom (yes vs. no) | 0.709 | 0.311-1.615 | 0.413 | 0.403 | 0.218-0.746 | 0.004 |
Ann Arbor stage (I/II vs. III/IV) | 0.601 | 0.204-1.765 | 0.354 | 1.423 | 1.008-1.861 | 0.010 |
Performance status (ECOG 0-1 vs. ≥ 2) | 0.454 | 0.223-0.922 | 0.029 | 2.867 | 1.586-5.182 | < 0.001 |
LDH level (normal vs. elevated) | 0.616 | 0.254-1.492 | 0.283 | 2.390 | 1.212-4.711 | 0.012 |
No. of extranodal sites (0-1 vs. ≥ 2) | 0.864 | 0.426-1.730 | 0.684 | 1.825 | 1.007-3.308 | 0.047 |
IPI score (0-2 vs. 3-5) | 0.596 | 0.156-2.227 | 0.449 | 3.137 | 1.715-5.738 | < 0.001 |
Bone marrow involvement (yes vs. no) | 1.922 | 0.848-4.353 | 0.117 | 1.236 | 0.632-2.418 | 0.536 |
Bulky tumor (yes vs. no) | 1.970 | 0.763-5.089 | 0.161 | 0.782 | 0.363-1.684 | 0.529 |
DID (< 10 mg/m2/wk vs. ≥ 10 mg/m2/wk) | 1.597 | 0.607-4.202 | 0.343 | 0.446 | 0.206-0.965 | 0.040 |
Cause | DID ≤ 10 mg/m2/wk | DID > 10 mg/m2/wk |
---|---|---|
Treatment related mortality | 4 (50.0) | 11 (28.9) |
Disease progression | 3 (37.5) | 14 (36.8) |
Unknown | 1 (12.5) | 9 (23.7) |
Secondary malignancy | 0 | 4 (10.5) |
DLBCL, diffuse large B cell lymphoma; R-CHOP, rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone; ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; IPI, International Prognostic Index.
p-value for 2-year PFS rate: (a+b) vs. (c+d+e+f)=0.036; (a) vs. (b)=0.271; (c) vs. (d)=0.362; (c) vs. (e)=0.462; (c) vs. (f)=0.392; (d) vs. (e)=0.782; (d) vs. (f)=0.913; (e) vs. (f)=0.815. p-value for 2-year OS rate: (a+b) vs. (c+d+e+f)=0.031; (a) vs. (b)=0.174; (c) vs. (d)=0.216; (c) vs. (e)=0.577; (c) vs. (f)=0.859; (d) vs. (e)=0.065; (d) vs. (f)=0.103; (e) vs. (f)=0.637. DID, dose intensity of doxorubicin; DLBCL, diffuse large B cell lymphoma; PFS, progression-free survival; OS, overall survival.
Values are presented as number (%) unless otherwise indicated. CR, complete remission; PFS, progression-free survival; HR, hazard ratio; CI, confidence interval; OS, overall survival.
HR, hazard ratio; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; IPI, International Prognostic Index; DID, dose intensity of doxorubicin.
Values are presented as number (%). DLBCL, diffuse large B cell lymphoma; DID, dose intensity of doxorubicin.