1Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
3Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
4Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
5Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
6Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea
7Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
8Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea
9Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
10Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
11Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
12Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
13Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
14Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
15Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
16Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
17Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
18Devision of Hematology-Oncology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
19Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
Copyright © 2018 by the Korean Cancer Association
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Treatment | No. of patients | Death | Disease progression |
Cause of death |
||
---|---|---|---|---|---|---|
Toxicity | Other cause | Unknown | ||||
R-CHOP | 124 | 63 | 17 | 22a) | 10 | 14 |
Other treatment | 41 | 19 | 3 | 7 | 3 | 6 |
No treatment | 29 | 25 | 13 | 0 | 6 | 6 |
Total | 194 | 107 | 33 | 29 | 19 | 26 |
Characteristic | No. (%) (n=194) |
---|---|
Sex | |
Male | 93 (47.9) |
Female | 101 (52.1) |
Age, median (range, yr) | 83.3 (80.1-95.7) |
Performance status (ECOG) | |
0-1 | 88 (45.4) |
2-4 | 106 (54.6) |
Ann Arbor stage (n=193) | |
I-II | 81 (42.0) |
III-IV | 112 (58.0) |
LDH level (n=192) | |
Normal | 73 (38.0) |
Abnormal | 119 (62.0) |
No. of extranodal sites (n=193) | |
< 2 | 154 (79.8) |
≥ 2 | 39 (20.2) |
aaIPI (n=192) | |
0 | 22 (11.5) |
1 | 56 (29.2) |
2 | 64 (33.3) |
3 | 50 (26.0) |
B symptoms | 41/176 (23.3) |
Bulky disease | 15/185 (8.1) |
Elevated β2-microglobulin | 64/89 (71.9) |
Anemia (hemoglobin < 12 g/dL) | 118/194 (60.8) |
Thrombocytopenia | 36/194 (18.6) |
Hypoalbuminemia (< 3.5 g/dL) | 82/193 (42.3) |
Renal failure (creatinine > 1.5 mg/dL) | 18/193 (9.3) |
Comorbidity (Charlson CSS) | |
0-3 | 146 (75.3) |
≥ 4 | 48 (24.7) |
Treatment | No. (%) |
---|---|
No treatment | 29 (14.9) |
Operation (tumor removal) | 2 (1.0) |
Radiation alone | 9 (4.6) |
First-line chemotherapy | 154 |
R-CHOP | 124 (63.9) |
R-CVP | 13 (6.7) |
CVP | 8 (4.1) |
R alone | 1 (0.5) |
Other | 8 (4.1) |
Second-line chemotherapy | 26 |
Third-line chemotherapy | 4 |
No. of patients | Relative dose intensity (%) |
TRD | |||||
---|---|---|---|---|---|---|---|
Rituximab | Cyclophosphamide | Adriamycin | Vincristine | Prednisone | |||
First cycle | 124 | 86.8 | 68.2 | 64.1 | 74.1 | 84.0 | 12 |
Second cycle | 95 | 84.8 | 65.0 | 60.0 | 70.4 | 80.1 | 2 |
Third cycle | 76 | 83.2 | 64.5 | 58.0 | 68.9 | 80.5 | 3 |
Fourth cycle | 53 | 81.3 | 62.5 | 58.0 | 68.3 | 80.7 | 0 |
Fifth cycle | 35 | 85.4 | 60.8 | 56.7 | 64.7 | 77.9 | 4 |
Sixth cycle | 24 | 96.9 | 69.6 | 65.5 | 80.3 | 89.9 | 0 |
Treatment | No. of patients | Death | Disease progression | Cause of death |
||
---|---|---|---|---|---|---|
Toxicity | Other cause | Unknown | ||||
R-CHOP | 124 | 63 | 17 | 22 |
10 | 14 |
Other treatment | 41 | 19 | 3 | 7 | 3 | 6 |
No treatment | 29 | 25 | 13 | 0 | 6 | 6 |
Total | 194 | 107 | 33 | 29 | 19 | 26 |
Prognostic factor | Survival (median±SE, mo) | p-value |
---|---|---|
aaIPI | ||
0 | Not reached | < 0.001 |
1 | 19.3±5.1 | |
2 | 14.0±6.5 | |
3 | 7.7±2.8 | |
ECOG | ||
0-1 | 24.3±11.2 | < 0.001 |
2-4 | 7.9±1.7 | |
Stage | ||
I-II | 18.5±6.5 | 0.088 |
III-IV | 11.1±2.2 | |
LDH | ||
Normal | 18.5±3.0 | 0.016 |
Elevated | 10.7±2.4 | |
No. of extranodal sites | ||
< 2 | 16.0±2.7 | 0.032 |
≥ 2 | 9.3±1.8 | |
Hemoglobin (g/dL) | ||
< 12 | 11.1±1.9 | 0.005 |
≥ 12 | 21.6 | |
Albumin (g/dL) | ||
< 3.5 | 6.4±0.9 | < 0.001 |
≥ 3.5 | 21.0±3.3 | |
Creatinine (mg/dL) | ||
< 1.5 | 16.9±2.6 | 0.001 |
≥ 1.5 | 4.6±2.8 | |
Comorbidity (Charlson CSS) | ||
< 4 | 17.5±3.1 | 0.013 |
≥ 4 | 10.4±1.8 | |
Treatment | ||
R-CHOP | 18.5±3.8 | < 0.001 |
Other treatment | 12.9±4.3 | |
No treatment | 2.7±1.9 |
Prognostic factor | Hazard ratio (95% CI) | p-value |
---|---|---|
aaIPI | 1.358 (1.082-1.704) | 0.008 |
Anemia | 1.276 (0.812-2.005) | 0.291 |
Hypoalbuminemia | 1.991 (1.292-3.069) | 0.002 |
Increased creatinine | 2.568 (1.424-4.632) | 0.002 |
Comorbidity (Charlson CSS) | 1.540 (0.987-2.403) | 0.057 |
No treatment | 1.642 (1.274-2.117) | < 0.001 |
Values are presented as number (%) unless otherwise indicated. ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; aaIPI, age-adjusted International Prognostic Index; CSS, comorbidity scoring system.
R-CHOP, rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone; R, rituximab; CVP, cyclophosphamide, vincristine, and prednisone.
TRD, treatment-related death; R-CHOP, rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone.
R-CHOP, rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone. One patient died due to treatment-related toxicity after salvage therapy.
SE, standard error; aaIPI, age-adjusted International Prognostic Index; ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; CSS, comorbidity scoring system; R-CHOP, rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone.
CI, confidence interval; aaIPI, age-adjusted International Prognostic Index; CSS, comorbidity scoring system.