PRO145 THE HUMANISTIC BURDEN OF SHORT-TERM ADVERSE EVENTS ASSOCIATED WITH THE CHOP CHEMOTHERAPY REGIMEN IN PATIENTS WITH LYMPHOPROLIFERATIVE DISORDERS IN EUROPEAN COUNTRIES: A COMPREHENSIVE LITERATURE REVIEW

Abstract

CHOP (vincristine, cyclophosphamide, prednisone, doxorubicin) is a treatment option for post-transplant lymphoproliferative disorder (PTLD) following solid organ transplant, an aggressive and potentially fatal disease. The objective of this study was to explore the humanistic burden of CHOP-associated adverse events (AEs) in PTLD patients. Since PTLD is a rare disease with limited available data, the search was expanded to all patients with lymphoproliferative disorders (LPD). CHOP-associated short-term AEs with an incidence of >4% in LPD patients were determined and sourced from the published literature and cancer websites. A comprehensive literature search was conducted using PubMed and EMBASE to identify humanistic burden studies published from 2000-2018 of the AEs associated with CHOP and its components in European countries. Overall, 3,946 non-duplicate citations were screened and 16 studies were included (none in PTLD). Studies were methodologically heterogenous. Febrile neutropenia (FN) was the AE most commonly encountered, followed by chemotherapy-induced (CI) anemia (A), infection, CI-nausea and vomiting (NV), and CI-peripheral neuropathy (PN). The humanistic burden of AEs was quantified via elicitation studies as well as a broad array of measures collected within retrospective or prospective studies, including cancer-specific, symptom-specific, and general health-related instruments. EORTC-QLQ-C30 was commonly used to document quality-of-life (QoL) impairment associated with toxicity-related AEs, with most detrimental CHOP effects normalizing over an extended period. CHOP-associated infection and CIPN significantly impacted the utility of patients as measured by this scale. CIA-related fatigue, measured by visual analogue scales and FACT-An, reduced patient QoL. Disutilities for CHOP-related AEs ranged from small (-0.050, CINV) to significant (-0.163, FN; -0.200, severe infection). Short-term AEs from CHOP in the LPD population were associated with substantial humanistic burden. This evidence highlights the absence of published data addressing the humanistic burden associated with chemotherapy in PTLD patients and highlights the need for effective and tolerable therapies.