RITUXIMAB DURING INDUCTION THERAPY MIGHT NOT IMPROVE OVERALL SURVIVAL OF VERY ELDERLY JAPANESE PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA
(Abstract release date: 05/19/16)
EHA Library. Miyata Y. 06/09/16; 134600; PB1700
Dr. Yasuhiko Miyata
Contributions
Contributions
Abstract
Abstract: PB1700
Type: Publication Only
Background
As aging of population is advancing, the number of the elderly patients with diffuse large B-cell lymphoma (DLBCL), most common type of lymphoma, is increasing. In addition to difficulty to treat patients age 80 and over due to comorbidities and poor organ functions, the optimal treatment of these patients with DLBCL remains unclear since there was no well-controlled, randomized trial to confirm clinical benefits of rituximab during induction therapy for these patients, unlike younger patients.
Aims
In this study, we assessed clinical contribution of rituximab during induction therapy on survival of Japanese patients with DLBCL age 80 and over, especially in actual practical setting.
Methods
Previously, we reported that rituximab-containing remission induction therapy improved the outcome of Japanese patients with mature B-cell lymphoma newly diagnosed at 20 National Hospital Organization hospitals from January 2000 to December 2004. A retrospective study was conducted using this database, although it lacks detailed information on treatment, e.g. combinations of drugs, dose intensities of each drug, and the number of treatment cycles.
Results
From database, we identified 100 patients age 80 and over (12.5%) from 798 DLBCL patients. Only 15 patients (15.0%) didn’t receive an anthracycline-containing regimen, and were excluded from further analyses. This ratio was statistically higher, compared to younger patients (p<0.0001). Among 85 patients who received anthracycline-containing regimens, 45 deaths were observed during follow-up period, and 8 deaths (17.8%) were due to other than lymphoma. This was not significant, compared to younger patients (p=0.859). Based on administration of rituximab in remission induction therapy, 85 patients were divided into two groups since patients didn’t receive rituximab during induction until its approval for DLBCL in September 2003 in Japan. Sixty-two patients (72.9%) were treated without rituximab (R- group) and 23 patients (27.1%) with rituximab (R+ group). Median follow-up periods were 38.7 months and 21.8 months, respectively. No significant difference of patient characteristics, age, sex, disease stage, extranodal involvement, B symptom, PS, LDH, IPI and AA-IPI, were observed between two groups. Better response was observed in R+ group than R- group (CRR 56.5% vs. 43.5%, ORR 82.6% vs. 66.1%), but these differences were not significant (p=0.3337 and p=0.183 respectively). Estimated 2-year progression-free survival of R+ group was significantly higher than R- group (50.4% vs. 25.6% p=0.030), but 2-year overall survival was similar (45.3% vs. 42.3% p= 0.344). The same trends were seen when deaths of other than lymphoma were censored (p=0.260). R- group was further divided into 2 groups, patients who never received rituximab throughout their lifetimes (R-R- group n=48) and those who received rituximab during salvage therapies (R-R+ group n=14). Median survivals of these groups were similar (19.2 months vs. 21.8 months p=0.900), and there was no significant difference from R+ group (p=0.351 and p=0.486 respectively).
Conclusion
Rituximab during induction therapy didn’t improve overall survival of Japanese patients with DLBCL age 80 and over, unlike younger patients. However, later administration of rituximab during salvage therapies could improve prognosis. Large-scale studies are further needed to confirm these results.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Elderly, Rituximab
Type: Publication Only
Background
As aging of population is advancing, the number of the elderly patients with diffuse large B-cell lymphoma (DLBCL), most common type of lymphoma, is increasing. In addition to difficulty to treat patients age 80 and over due to comorbidities and poor organ functions, the optimal treatment of these patients with DLBCL remains unclear since there was no well-controlled, randomized trial to confirm clinical benefits of rituximab during induction therapy for these patients, unlike younger patients.
Aims
In this study, we assessed clinical contribution of rituximab during induction therapy on survival of Japanese patients with DLBCL age 80 and over, especially in actual practical setting.
Methods
Previously, we reported that rituximab-containing remission induction therapy improved the outcome of Japanese patients with mature B-cell lymphoma newly diagnosed at 20 National Hospital Organization hospitals from January 2000 to December 2004. A retrospective study was conducted using this database, although it lacks detailed information on treatment, e.g. combinations of drugs, dose intensities of each drug, and the number of treatment cycles.
Results
From database, we identified 100 patients age 80 and over (12.5%) from 798 DLBCL patients. Only 15 patients (15.0%) didn’t receive an anthracycline-containing regimen, and were excluded from further analyses. This ratio was statistically higher, compared to younger patients (p<0.0001). Among 85 patients who received anthracycline-containing regimens, 45 deaths were observed during follow-up period, and 8 deaths (17.8%) were due to other than lymphoma. This was not significant, compared to younger patients (p=0.859). Based on administration of rituximab in remission induction therapy, 85 patients were divided into two groups since patients didn’t receive rituximab during induction until its approval for DLBCL in September 2003 in Japan. Sixty-two patients (72.9%) were treated without rituximab (R- group) and 23 patients (27.1%) with rituximab (R+ group). Median follow-up periods were 38.7 months and 21.8 months, respectively. No significant difference of patient characteristics, age, sex, disease stage, extranodal involvement, B symptom, PS, LDH, IPI and AA-IPI, were observed between two groups. Better response was observed in R+ group than R- group (CRR 56.5% vs. 43.5%, ORR 82.6% vs. 66.1%), but these differences were not significant (p=0.3337 and p=0.183 respectively). Estimated 2-year progression-free survival of R+ group was significantly higher than R- group (50.4% vs. 25.6% p=0.030), but 2-year overall survival was similar (45.3% vs. 42.3% p= 0.344). The same trends were seen when deaths of other than lymphoma were censored (p=0.260). R- group was further divided into 2 groups, patients who never received rituximab throughout their lifetimes (R-R- group n=48) and those who received rituximab during salvage therapies (R-R+ group n=14). Median survivals of these groups were similar (19.2 months vs. 21.8 months p=0.900), and there was no significant difference from R+ group (p=0.351 and p=0.486 respectively).
Conclusion
Rituximab during induction therapy didn’t improve overall survival of Japanese patients with DLBCL age 80 and over, unlike younger patients. However, later administration of rituximab during salvage therapies could improve prognosis. Large-scale studies are further needed to confirm these results.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Elderly, Rituximab
Abstract: PB1700
Type: Publication Only
Background
As aging of population is advancing, the number of the elderly patients with diffuse large B-cell lymphoma (DLBCL), most common type of lymphoma, is increasing. In addition to difficulty to treat patients age 80 and over due to comorbidities and poor organ functions, the optimal treatment of these patients with DLBCL remains unclear since there was no well-controlled, randomized trial to confirm clinical benefits of rituximab during induction therapy for these patients, unlike younger patients.
Aims
In this study, we assessed clinical contribution of rituximab during induction therapy on survival of Japanese patients with DLBCL age 80 and over, especially in actual practical setting.
Methods
Previously, we reported that rituximab-containing remission induction therapy improved the outcome of Japanese patients with mature B-cell lymphoma newly diagnosed at 20 National Hospital Organization hospitals from January 2000 to December 2004. A retrospective study was conducted using this database, although it lacks detailed information on treatment, e.g. combinations of drugs, dose intensities of each drug, and the number of treatment cycles.
Results
From database, we identified 100 patients age 80 and over (12.5%) from 798 DLBCL patients. Only 15 patients (15.0%) didn’t receive an anthracycline-containing regimen, and were excluded from further analyses. This ratio was statistically higher, compared to younger patients (p<0.0001). Among 85 patients who received anthracycline-containing regimens, 45 deaths were observed during follow-up period, and 8 deaths (17.8%) were due to other than lymphoma. This was not significant, compared to younger patients (p=0.859). Based on administration of rituximab in remission induction therapy, 85 patients were divided into two groups since patients didn’t receive rituximab during induction until its approval for DLBCL in September 2003 in Japan. Sixty-two patients (72.9%) were treated without rituximab (R- group) and 23 patients (27.1%) with rituximab (R+ group). Median follow-up periods were 38.7 months and 21.8 months, respectively. No significant difference of patient characteristics, age, sex, disease stage, extranodal involvement, B symptom, PS, LDH, IPI and AA-IPI, were observed between two groups. Better response was observed in R+ group than R- group (CRR 56.5% vs. 43.5%, ORR 82.6% vs. 66.1%), but these differences were not significant (p=0.3337 and p=0.183 respectively). Estimated 2-year progression-free survival of R+ group was significantly higher than R- group (50.4% vs. 25.6% p=0.030), but 2-year overall survival was similar (45.3% vs. 42.3% p= 0.344). The same trends were seen when deaths of other than lymphoma were censored (p=0.260). R- group was further divided into 2 groups, patients who never received rituximab throughout their lifetimes (R-R- group n=48) and those who received rituximab during salvage therapies (R-R+ group n=14). Median survivals of these groups were similar (19.2 months vs. 21.8 months p=0.900), and there was no significant difference from R+ group (p=0.351 and p=0.486 respectively).
Conclusion
Rituximab during induction therapy didn’t improve overall survival of Japanese patients with DLBCL age 80 and over, unlike younger patients. However, later administration of rituximab during salvage therapies could improve prognosis. Large-scale studies are further needed to confirm these results.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Elderly, Rituximab
Type: Publication Only
Background
As aging of population is advancing, the number of the elderly patients with diffuse large B-cell lymphoma (DLBCL), most common type of lymphoma, is increasing. In addition to difficulty to treat patients age 80 and over due to comorbidities and poor organ functions, the optimal treatment of these patients with DLBCL remains unclear since there was no well-controlled, randomized trial to confirm clinical benefits of rituximab during induction therapy for these patients, unlike younger patients.
Aims
In this study, we assessed clinical contribution of rituximab during induction therapy on survival of Japanese patients with DLBCL age 80 and over, especially in actual practical setting.
Methods
Previously, we reported that rituximab-containing remission induction therapy improved the outcome of Japanese patients with mature B-cell lymphoma newly diagnosed at 20 National Hospital Organization hospitals from January 2000 to December 2004. A retrospective study was conducted using this database, although it lacks detailed information on treatment, e.g. combinations of drugs, dose intensities of each drug, and the number of treatment cycles.
Results
From database, we identified 100 patients age 80 and over (12.5%) from 798 DLBCL patients. Only 15 patients (15.0%) didn’t receive an anthracycline-containing regimen, and were excluded from further analyses. This ratio was statistically higher, compared to younger patients (p<0.0001). Among 85 patients who received anthracycline-containing regimens, 45 deaths were observed during follow-up period, and 8 deaths (17.8%) were due to other than lymphoma. This was not significant, compared to younger patients (p=0.859). Based on administration of rituximab in remission induction therapy, 85 patients were divided into two groups since patients didn’t receive rituximab during induction until its approval for DLBCL in September 2003 in Japan. Sixty-two patients (72.9%) were treated without rituximab (R- group) and 23 patients (27.1%) with rituximab (R+ group). Median follow-up periods were 38.7 months and 21.8 months, respectively. No significant difference of patient characteristics, age, sex, disease stage, extranodal involvement, B symptom, PS, LDH, IPI and AA-IPI, were observed between two groups. Better response was observed in R+ group than R- group (CRR 56.5% vs. 43.5%, ORR 82.6% vs. 66.1%), but these differences were not significant (p=0.3337 and p=0.183 respectively). Estimated 2-year progression-free survival of R+ group was significantly higher than R- group (50.4% vs. 25.6% p=0.030), but 2-year overall survival was similar (45.3% vs. 42.3% p= 0.344). The same trends were seen when deaths of other than lymphoma were censored (p=0.260). R- group was further divided into 2 groups, patients who never received rituximab throughout their lifetimes (R-R- group n=48) and those who received rituximab during salvage therapies (R-R+ group n=14). Median survivals of these groups were similar (19.2 months vs. 21.8 months p=0.900), and there was no significant difference from R+ group (p=0.351 and p=0.486 respectively).
Conclusion
Rituximab during induction therapy didn’t improve overall survival of Japanese patients with DLBCL age 80 and over, unlike younger patients. However, later administration of rituximab during salvage therapies could improve prognosis. Large-scale studies are further needed to confirm these results.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Elderly, Rituximab
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