DOSE ADJUSTED REPOCH IN UNTREATED DE NOVO DIFFUSE LARGE B CELL LYMPHOMA - A SINGLE CENTRE SINGAPORE EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. Tso A. 06/09/16; 134593; PB1693
Dr. Allison Ching Yee Tso
Contributions
Contributions
Abstract
Abstract: PB1693
Type: Publication Only
Background
The current standard of care for untreated Diffuse Large B Cell Lymphoma (DLBCL) remains as Rituximab plus CHOP chemotherapy (RCHOP). Some studies suggested that certain subtypes of DLBCL respond better to dose adjusted REPOCH. However, data comparing the efficacy of RCHOP with REPOCH is scarce.
Aims
To compare the outcome of untreated de novo DLBCL of dose adjusted REPOCH chemotherapy with historical controls.
Methods
This is a retrospective analysis of all patients between age 18 – 70 with any stage of treatment naïve de novo DLBCL; who received RCHOP chemotherapy between 2009 to 2013, and REPOCH chemotherapy between 2013 to 2016. DLBCLs that were transformed from low grade lymphomas were excluded. Demography, histology, stage, immunohistochemistry biomarkers for cell of origin (GCB versus ABC using Hans algorithm), cytogenetics, details of chemotherapy, responses and duration of follow-up were included for analysis. 2 years overall survival (OS) and progression free survival (PFS) were calculated.
Results
46 evaluable patients were followed up between 2009 and 2016 with 20 in the RCHOP cohort and 26 in the REPOCH cohort. The characteristics between the RCHOP and REPOCH groups were comparable: average age were 54 and 53.9 years respectively, 15 of 20 (75%) and 18 of 26 (69%) patients had stage 3 or 4 disease respectively. 50% and 20% of the RCHOP group; and 73% and 23% of the REPOCH group have the ABC and GCB subtypes of DLBCL respectively. The median follow-up period for the RCHOP and REPOCH groups were 40.5 (range 8 -70) and 16 (range 3 - 35) months. Kaplain Meier survival curves showed that the OS and PFS of REPOCH were greater than that of RCHOP, although they were not statistically significant (OS Log-rank test: z=0.71, p=0.48; PFS Log-rank test: z=1.52, p=0.13). The 2 years OS of the RCHOP and REPOCH groups were 89% and 100% respectively; and the 2 years PFS of the RCHOP and REPOCH groups were 75% and 95% respectively.
Conclusion
In the literature, the GCB subtype is generally more than twice as common as the ABC subtype and confers a better overall outcome. In our institution, the ABC subtype was around 3 times more prevalent than the GCB subtype, suggesting the biology of the disease may differ with ethnicity and imply a more aggressive phenotype. Although our data suggests REPOCH to be superior to RCHOP in treatment naïve de novo DLBCL patients, a longer follow-up period may be required to observe a statistical difference in the OS and PFS. Further prospective randomized comparison between these two regimens in the Asian population is warranted.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
Type: Publication Only
Background
The current standard of care for untreated Diffuse Large B Cell Lymphoma (DLBCL) remains as Rituximab plus CHOP chemotherapy (RCHOP). Some studies suggested that certain subtypes of DLBCL respond better to dose adjusted REPOCH. However, data comparing the efficacy of RCHOP with REPOCH is scarce.
Aims
To compare the outcome of untreated de novo DLBCL of dose adjusted REPOCH chemotherapy with historical controls.
Methods
This is a retrospective analysis of all patients between age 18 – 70 with any stage of treatment naïve de novo DLBCL; who received RCHOP chemotherapy between 2009 to 2013, and REPOCH chemotherapy between 2013 to 2016. DLBCLs that were transformed from low grade lymphomas were excluded. Demography, histology, stage, immunohistochemistry biomarkers for cell of origin (GCB versus ABC using Hans algorithm), cytogenetics, details of chemotherapy, responses and duration of follow-up were included for analysis. 2 years overall survival (OS) and progression free survival (PFS) were calculated.
Results
46 evaluable patients were followed up between 2009 and 2016 with 20 in the RCHOP cohort and 26 in the REPOCH cohort. The characteristics between the RCHOP and REPOCH groups were comparable: average age were 54 and 53.9 years respectively, 15 of 20 (75%) and 18 of 26 (69%) patients had stage 3 or 4 disease respectively. 50% and 20% of the RCHOP group; and 73% and 23% of the REPOCH group have the ABC and GCB subtypes of DLBCL respectively. The median follow-up period for the RCHOP and REPOCH groups were 40.5 (range 8 -70) and 16 (range 3 - 35) months. Kaplain Meier survival curves showed that the OS and PFS of REPOCH were greater than that of RCHOP, although they were not statistically significant (OS Log-rank test: z=0.71, p=0.48; PFS Log-rank test: z=1.52, p=0.13). The 2 years OS of the RCHOP and REPOCH groups were 89% and 100% respectively; and the 2 years PFS of the RCHOP and REPOCH groups were 75% and 95% respectively.
Conclusion
In the literature, the GCB subtype is generally more than twice as common as the ABC subtype and confers a better overall outcome. In our institution, the ABC subtype was around 3 times more prevalent than the GCB subtype, suggesting the biology of the disease may differ with ethnicity and imply a more aggressive phenotype. Although our data suggests REPOCH to be superior to RCHOP in treatment naïve de novo DLBCL patients, a longer follow-up period may be required to observe a statistical difference in the OS and PFS. Further prospective randomized comparison between these two regimens in the Asian population is warranted.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
Abstract: PB1693
Type: Publication Only
Background
The current standard of care for untreated Diffuse Large B Cell Lymphoma (DLBCL) remains as Rituximab plus CHOP chemotherapy (RCHOP). Some studies suggested that certain subtypes of DLBCL respond better to dose adjusted REPOCH. However, data comparing the efficacy of RCHOP with REPOCH is scarce.
Aims
To compare the outcome of untreated de novo DLBCL of dose adjusted REPOCH chemotherapy with historical controls.
Methods
This is a retrospective analysis of all patients between age 18 – 70 with any stage of treatment naïve de novo DLBCL; who received RCHOP chemotherapy between 2009 to 2013, and REPOCH chemotherapy between 2013 to 2016. DLBCLs that were transformed from low grade lymphomas were excluded. Demography, histology, stage, immunohistochemistry biomarkers for cell of origin (GCB versus ABC using Hans algorithm), cytogenetics, details of chemotherapy, responses and duration of follow-up were included for analysis. 2 years overall survival (OS) and progression free survival (PFS) were calculated.
Results
46 evaluable patients were followed up between 2009 and 2016 with 20 in the RCHOP cohort and 26 in the REPOCH cohort. The characteristics between the RCHOP and REPOCH groups were comparable: average age were 54 and 53.9 years respectively, 15 of 20 (75%) and 18 of 26 (69%) patients had stage 3 or 4 disease respectively. 50% and 20% of the RCHOP group; and 73% and 23% of the REPOCH group have the ABC and GCB subtypes of DLBCL respectively. The median follow-up period for the RCHOP and REPOCH groups were 40.5 (range 8 -70) and 16 (range 3 - 35) months. Kaplain Meier survival curves showed that the OS and PFS of REPOCH were greater than that of RCHOP, although they were not statistically significant (OS Log-rank test: z=0.71, p=0.48; PFS Log-rank test: z=1.52, p=0.13). The 2 years OS of the RCHOP and REPOCH groups were 89% and 100% respectively; and the 2 years PFS of the RCHOP and REPOCH groups were 75% and 95% respectively.
Conclusion
In the literature, the GCB subtype is generally more than twice as common as the ABC subtype and confers a better overall outcome. In our institution, the ABC subtype was around 3 times more prevalent than the GCB subtype, suggesting the biology of the disease may differ with ethnicity and imply a more aggressive phenotype. Although our data suggests REPOCH to be superior to RCHOP in treatment naïve de novo DLBCL patients, a longer follow-up period may be required to observe a statistical difference in the OS and PFS. Further prospective randomized comparison between these two regimens in the Asian population is warranted.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
Type: Publication Only
Background
The current standard of care for untreated Diffuse Large B Cell Lymphoma (DLBCL) remains as Rituximab plus CHOP chemotherapy (RCHOP). Some studies suggested that certain subtypes of DLBCL respond better to dose adjusted REPOCH. However, data comparing the efficacy of RCHOP with REPOCH is scarce.
Aims
To compare the outcome of untreated de novo DLBCL of dose adjusted REPOCH chemotherapy with historical controls.
Methods
This is a retrospective analysis of all patients between age 18 – 70 with any stage of treatment naïve de novo DLBCL; who received RCHOP chemotherapy between 2009 to 2013, and REPOCH chemotherapy between 2013 to 2016. DLBCLs that were transformed from low grade lymphomas were excluded. Demography, histology, stage, immunohistochemistry biomarkers for cell of origin (GCB versus ABC using Hans algorithm), cytogenetics, details of chemotherapy, responses and duration of follow-up were included for analysis. 2 years overall survival (OS) and progression free survival (PFS) were calculated.
Results
46 evaluable patients were followed up between 2009 and 2016 with 20 in the RCHOP cohort and 26 in the REPOCH cohort. The characteristics between the RCHOP and REPOCH groups were comparable: average age were 54 and 53.9 years respectively, 15 of 20 (75%) and 18 of 26 (69%) patients had stage 3 or 4 disease respectively. 50% and 20% of the RCHOP group; and 73% and 23% of the REPOCH group have the ABC and GCB subtypes of DLBCL respectively. The median follow-up period for the RCHOP and REPOCH groups were 40.5 (range 8 -70) and 16 (range 3 - 35) months. Kaplain Meier survival curves showed that the OS and PFS of REPOCH were greater than that of RCHOP, although they were not statistically significant (OS Log-rank test: z=0.71, p=0.48; PFS Log-rank test: z=1.52, p=0.13). The 2 years OS of the RCHOP and REPOCH groups were 89% and 100% respectively; and the 2 years PFS of the RCHOP and REPOCH groups were 75% and 95% respectively.
Conclusion
In the literature, the GCB subtype is generally more than twice as common as the ABC subtype and confers a better overall outcome. In our institution, the ABC subtype was around 3 times more prevalent than the GCB subtype, suggesting the biology of the disease may differ with ethnicity and imply a more aggressive phenotype. Although our data suggests REPOCH to be superior to RCHOP in treatment naïve de novo DLBCL patients, a longer follow-up period may be required to observe a statistical difference in the OS and PFS. Further prospective randomized comparison between these two regimens in the Asian population is warranted.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
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