R-CHOP-21 PLUS LOW DOSE ETOPOSIDE VERSUS DA-EPOCH-R IN PATIENTS WITH AIDS-RELATED GCB DIFFUSE LARGE CELL B CELL LYMPHOMA; SINGLE CENTRE EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. Kozlov I. 06/09/16; 134587; PB1687
Dr. Iurii Kozlov
Contributions
Contributions
Abstract
Abstract: PB1687
Type: Publication Only
Background
Treatment of AIDS-related diffuse large cell B cell lymphoma (DLBCL) with low CD4 count (<100 mm3) remains a great challenge for hematologists. Balancing between competing needs of lymphoma treatment and HIV management is crucial for achieving long term survival. Previous studies have shown strong advantage of DA-EPOCH-R versus R-CHOP in AIDS-related lymphomas. However hematological toxicity profile of this regimen is quite considerable especially in patients with AIDS with decreased bone marrow reserves. Combination of standard R-CHOP with low dose etoposide (R-CHOEP) could be effective alternative option in AIDS-related GCB-type DLBCL management.
Aims
The aim of our study was to evaluate if R-CHOEP benefit of R-DA-EPOCH in patients with AIDS-related GCB DLBCL considering hematological toxicity.
Methods
Thirty one patients (pts) with AIDS-related GCB DLBCL have been enrolled in study. All pts had low CD4 count with mean amount 78 cells/mm3 and did not receive HAART before the enrolment. They have been divided into two arms. First arm (n=14) received standard R-CHOP with 50 mg/m2 etoposide infusion on days 1-3. Second arm received DA-EPOCH-R as it has been described in previous studies. FDG-PET scans have been done before and after the treatment.
Results
Complete response (CR) has been achieved in 93% in DA-EPOCH-R arm and in 85% in R-CHOEP arm. Hematological toxicities have been observed in both arms in all cycles of treatment. However in DA-EPOCH-R arm neutropenia mean period was 16 days when in R-CHOEP arm 11 days; thrombocytopenia period was 11 and 3 days respectively. Septic complications in DA-EPOCH-R arm have been observed in 53% when in R-CHOEP arm in 31%.
Conclusion
Patients treated with R-CHOEP had shorter periods of neutropenia and thrombocytopenia in comparison with DA-EPOCH-R group, where periods of neutropenia and thrombocytopenia were longer and resulted in higher rate of infectious complications. Considering comparable CR rate in both groups R-CHOP plus low dose etoposide could be effective option with lower hematological toxicity profile in AIDS-related DLBCL with CD4 count less than 100 cells/mm3.
Session topic: E-poster
Type: Publication Only
Background
Treatment of AIDS-related diffuse large cell B cell lymphoma (DLBCL) with low CD4 count (<100 mm3) remains a great challenge for hematologists. Balancing between competing needs of lymphoma treatment and HIV management is crucial for achieving long term survival. Previous studies have shown strong advantage of DA-EPOCH-R versus R-CHOP in AIDS-related lymphomas. However hematological toxicity profile of this regimen is quite considerable especially in patients with AIDS with decreased bone marrow reserves. Combination of standard R-CHOP with low dose etoposide (R-CHOEP) could be effective alternative option in AIDS-related GCB-type DLBCL management.
Aims
The aim of our study was to evaluate if R-CHOEP benefit of R-DA-EPOCH in patients with AIDS-related GCB DLBCL considering hematological toxicity.
Methods
Thirty one patients (pts) with AIDS-related GCB DLBCL have been enrolled in study. All pts had low CD4 count with mean amount 78 cells/mm3 and did not receive HAART before the enrolment. They have been divided into two arms. First arm (n=14) received standard R-CHOP with 50 mg/m2 etoposide infusion on days 1-3. Second arm received DA-EPOCH-R as it has been described in previous studies. FDG-PET scans have been done before and after the treatment.
Results
Complete response (CR) has been achieved in 93% in DA-EPOCH-R arm and in 85% in R-CHOEP arm. Hematological toxicities have been observed in both arms in all cycles of treatment. However in DA-EPOCH-R arm neutropenia mean period was 16 days when in R-CHOEP arm 11 days; thrombocytopenia period was 11 and 3 days respectively. Septic complications in DA-EPOCH-R arm have been observed in 53% when in R-CHOEP arm in 31%.
Conclusion
Patients treated with R-CHOEP had shorter periods of neutropenia and thrombocytopenia in comparison with DA-EPOCH-R group, where periods of neutropenia and thrombocytopenia were longer and resulted in higher rate of infectious complications. Considering comparable CR rate in both groups R-CHOP plus low dose etoposide could be effective option with lower hematological toxicity profile in AIDS-related DLBCL with CD4 count less than 100 cells/mm3.
Session topic: E-poster
Abstract: PB1687
Type: Publication Only
Background
Treatment of AIDS-related diffuse large cell B cell lymphoma (DLBCL) with low CD4 count (<100 mm3) remains a great challenge for hematologists. Balancing between competing needs of lymphoma treatment and HIV management is crucial for achieving long term survival. Previous studies have shown strong advantage of DA-EPOCH-R versus R-CHOP in AIDS-related lymphomas. However hematological toxicity profile of this regimen is quite considerable especially in patients with AIDS with decreased bone marrow reserves. Combination of standard R-CHOP with low dose etoposide (R-CHOEP) could be effective alternative option in AIDS-related GCB-type DLBCL management.
Aims
The aim of our study was to evaluate if R-CHOEP benefit of R-DA-EPOCH in patients with AIDS-related GCB DLBCL considering hematological toxicity.
Methods
Thirty one patients (pts) with AIDS-related GCB DLBCL have been enrolled in study. All pts had low CD4 count with mean amount 78 cells/mm3 and did not receive HAART before the enrolment. They have been divided into two arms. First arm (n=14) received standard R-CHOP with 50 mg/m2 etoposide infusion on days 1-3. Second arm received DA-EPOCH-R as it has been described in previous studies. FDG-PET scans have been done before and after the treatment.
Results
Complete response (CR) has been achieved in 93% in DA-EPOCH-R arm and in 85% in R-CHOEP arm. Hematological toxicities have been observed in both arms in all cycles of treatment. However in DA-EPOCH-R arm neutropenia mean period was 16 days when in R-CHOEP arm 11 days; thrombocytopenia period was 11 and 3 days respectively. Septic complications in DA-EPOCH-R arm have been observed in 53% when in R-CHOEP arm in 31%.
Conclusion
Patients treated with R-CHOEP had shorter periods of neutropenia and thrombocytopenia in comparison with DA-EPOCH-R group, where periods of neutropenia and thrombocytopenia were longer and resulted in higher rate of infectious complications. Considering comparable CR rate in both groups R-CHOP plus low dose etoposide could be effective option with lower hematological toxicity profile in AIDS-related DLBCL with CD4 count less than 100 cells/mm3.
Session topic: E-poster
Type: Publication Only
Background
Treatment of AIDS-related diffuse large cell B cell lymphoma (DLBCL) with low CD4 count (<100 mm3) remains a great challenge for hematologists. Balancing between competing needs of lymphoma treatment and HIV management is crucial for achieving long term survival. Previous studies have shown strong advantage of DA-EPOCH-R versus R-CHOP in AIDS-related lymphomas. However hematological toxicity profile of this regimen is quite considerable especially in patients with AIDS with decreased bone marrow reserves. Combination of standard R-CHOP with low dose etoposide (R-CHOEP) could be effective alternative option in AIDS-related GCB-type DLBCL management.
Aims
The aim of our study was to evaluate if R-CHOEP benefit of R-DA-EPOCH in patients with AIDS-related GCB DLBCL considering hematological toxicity.
Methods
Thirty one patients (pts) with AIDS-related GCB DLBCL have been enrolled in study. All pts had low CD4 count with mean amount 78 cells/mm3 and did not receive HAART before the enrolment. They have been divided into two arms. First arm (n=14) received standard R-CHOP with 50 mg/m2 etoposide infusion on days 1-3. Second arm received DA-EPOCH-R as it has been described in previous studies. FDG-PET scans have been done before and after the treatment.
Results
Complete response (CR) has been achieved in 93% in DA-EPOCH-R arm and in 85% in R-CHOEP arm. Hematological toxicities have been observed in both arms in all cycles of treatment. However in DA-EPOCH-R arm neutropenia mean period was 16 days when in R-CHOEP arm 11 days; thrombocytopenia period was 11 and 3 days respectively. Septic complications in DA-EPOCH-R arm have been observed in 53% when in R-CHOEP arm in 31%.
Conclusion
Patients treated with R-CHOEP had shorter periods of neutropenia and thrombocytopenia in comparison with DA-EPOCH-R group, where periods of neutropenia and thrombocytopenia were longer and resulted in higher rate of infectious complications. Considering comparable CR rate in both groups R-CHOP plus low dose etoposide could be effective option with lower hematological toxicity profile in AIDS-related DLBCL with CD4 count less than 100 cells/mm3.
Session topic: E-poster
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