Reduced relative dose intensity of primary chemotherapy does not influence prognosis of patients with Hodgkin lymphoma

Ludek Raida,Dana Cahova,Zuzana Rusinakova,Karel Indrak,Edgar Faber,Vit Prochazka,Tomas Papajik,Pavel Tucek

doi:10.5507/bp.2013.022

Ludek Raida, Dana Cahova + Show 6 more

Open Access

https://doi.org/10.5507/bp.2013.022

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Journal: Biomedical Papers	Publication Date: Apr 10, 2013
Citations: 2	License type: cc-by

Affiliation: Palacký University, Olomouc

Abstract

A retrospective analysis of patients with Hodgkin lymphoma (HL) was performed to assess their outcome regarding relative dose intensity (RDI) of chemotherapy administered in primary treatment. A total of 194 patients were divided into three groups with different RDI of primary chemotherapy (100%, 90-99% and <90%). Reduced RDI in two groups (90-99% and <90%) was caused by the delay of the interval between the administration of some chemotherapeutic courses. The probability of complete remission (CR), disease relapse, event-free survival (EFS) and overall survival (OS) as the basic parameters of patient outcome were statistically compared. Multivariate analysis showed here were no significant differences in probability of CR (HR 0.9, 95% CI [0.75-1.08], P=0.5), risk of relapse (HR 1.34, 95% CI [0.92-1.94], P=0.11) or death (HR 1.52, 95% CI [0.94-2.5], P=0.13). There were also no significant differences in probability of EFS (mean 13 vs. 10 vs. 12 years, P=0.17; HR 1.54, 95% CI [0.91-2.6], P=0.22) or OS (mean 15 vs. 13 vs. 14 years, P=0.13; HR 1.52, 95% CI [0.93-2.5], P=0.13). We found no significant impact of primary chemotherapy delay resulting in reduced RDI on outcome in HL patients.

Highlights

Over the last decades, the therapeutic outcome of Hodgkin lymphoma (HL) patients has dramatically improved
We found no significant impact of primary chemotherapy delay resulting in reduced relative dose intensity (RDI) on outcome in HL patients
No differences between the RDI groups were found for patient gender and age, manifestation of B symptoms, nodal bulk, erythrocyte sedimentation rate (ESR), white blood cells (WBC), absolute lymphocyte count (ALC) (Table 1), chemotherapeutic protocols and RT used in the primary treatment of HL (Table 2)

Summary

Introduction

The therapeutic outcome of Hodgkin lymphoma (HL) patients has dramatically improved. We found no significant impact of primary chemotherapy delay resulting in reduced RDI on outcome in HL patients. The relative dose intensity (RDI) of primary chemotherapy can be reduced in a significant proportion of patients, even those in the early stage of disease and treated with less intensive protocols.

Results

Conclusion