Abstract
Background and objectiveThe Hyper-CVAD/Methotrexate-Cytarabine (H-CVAD/MTX-AraC) chemotherapy protocol has been one of the standard treatments for blood cancers, such as Mantle cell lymphoma (MCL), Burkitt’s lymphoma (BL) and B-cell and T-cell acute lymphoblastic leukaemia (ALL). Due to high toxicity, it has been progressively replaced with new specific regimens with a better safety profile (GELA protocol for MCL, BURKIMAB for BL and PETHEMA for B-cell and T-cell ALL). The objective of this study is to analyse the toxicity and infectious complications of these therapeutic regimens, as well as the event free survival (EFS).Patients and methodsThis is a retrospective and descriptive observational study of 81 patients, comparing 42 patients treated with H-CVAD/MTX-AraC (group A) versus 39 patients treated with GELA/BURKIMAB/PETHEMA (group B).ResultsAll patients in group A developed pancytopenia, but in group B 74.4% neutropenia, 51.3% thrombocytopenia and 69.2% anaemia. The total number of infections in group A was higher than in group B: 154 versus 48, 3.67 versus 1.23 per patient and 0.59 versus 0.25 per cycle. Likewise, febrile neutropenia happened: 106 versus 21 cases, 2.52 versus 0.52 per patient and 0.41 versus 0.11 per cycle. EVS is higher in group B: 33% versus 79% (2-year), and 24% versus 69% (5-year).ConclusionsCurrent therapeutic protocols have shown higher EFS due to better safety profile, with less haematological, neurological and haemorrhagic toxicity, as well as lower rates of infectious complications.
Highlights
Lymphomas and acute leukaemias are blood cancers with high morbidity and mortality rates
Patients and methods: This is a retrospective and descriptive observational study of 81 patients, comparing 42 patients treated with H-CVAD/MTX-AraC versus 39 patients treated with GELA/BURKIMAB/PETHEMA
Since 2000, the combined Hyper-CVAD/Methotrexate-Cytarabine (H-CVAD/MTX-AraC) protocol has been the treatment regimen of choice used in many centres for cancers such as Mantle cell lymphoma (MCL) [4], Burkitt’s lymphoma (BL) [5] and acute lymphoblastic leukaemia (ALL), type B (B-cell ALL) and type T (T-cell ALL) [6]
Summary
Lymphomas and acute leukaemias are blood cancers with high morbidity and mortality rates. Since 2000, the combined Hyper-CVAD/Methotrexate-Cytarabine (H-CVAD/MTX-AraC) protocol has been the treatment regimen of choice used in many centres for cancers such as Mantle cell lymphoma (MCL) [4], Burkitt’s lymphoma (BL) [5] and acute lymphoblastic leukaemia (ALL), type B (B-cell ALL) and type T (T-cell ALL) [6]. The objective of this study is to analyse the toxicity and infectious complications of these therapeutic regimens, as well as the event free survival (EFS)
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