LATE MYELOTOXICITY OF INTENSIVE MODIFIED PROGRAM NHL-BFM-90 IN ADULT POOR-PROGNOSIS PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA.
(Abstract release date: 05/19/16)
EHA Library. Dorokhina E. 06/09/16; 134638; PB1738
Dr. Elena Dorokhina
Contributions
Contributions
Abstract
Abstract: PB1738
Type: Publication Only
Background
High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.
Aims
To evaluate late myelotoxicity of intensive modified program NHL-BFM-90 (mNHL-BFM-90) in adult poor-prognosis patients with diffuse large B-cell lymphoma (DLBCL).
Methods
Results of complex clinical, laboratory and instrumental examination, including cytological, histological and standard cytogenetic bone marrow study of 40 patients with DLBCL which received mNHL-BFM-90 protocol in the Hematology Research Center in the period since 2002 till 2009 years were analyzed. Group consisted of 20 men, 20 women, median age – 57 (31-76) years at the time of survey. Comparison group included 19 patients (8 men and 11 women), median age – 70 (39-80) years at the time of survey, who received CHOP /R-CHOP-21 therapy. Median follow-up after completion of treatment - 6 years. Results of study of bone marrow were analyzed before chemotherapy and after 5-10 years after treatment. Cellularity of bone marrow, the amount of erythroid, granulocytic and megakaryocytic germs, signs of dysplasia, and dysplastic changes of stroma were determined by histologically and cytologically. Also performs standard cytogenetic bone marrow examination to identify karyological violations. As late myelotoxicity were considered signs of toxic damage of bone marrow, which appeared first time in late period after chemotherapy . Cases with initially presented and preserved after chemotherapy myelotoxicity signs, as well as presence and absence of baseline after chemotherapy – weren’t taken into account.
Results
Cytopenia (with no signs of myelodysplasia and substitutive transfusions of blood components need) were detected in 52% of patients with high-dose group, 46% of cases are accounted for thrombocytopenia. Reduced cellularity of bone marrow in 15 (38%) patients, p = 0.02, reducing of erythroid and megakaryocytic germs in 13 (33%), p =0.01, and 19 (48%), p = 0.009, respectively, stroma changes in 17 (43%) patients, p = 0.02, were revealed like signs of late myelotoxicity in patients after high-dose chemotherapy for mNHL-BFM-90 program.Standard cytogenetic study of bone marrow was performed for first six patients, all had a normal karyotype, without any karyological abnormalities, therefore further study wasn’t performed.
Conclusion
Long-term myelotoxicity of high-dose program mNHL-BFM-90 exceeds significantly toxicity of standard therapy CHOP / R-CHOP-21. However, myelodysplastic syndromes or cytopenia requiring transfusions of blood components wasn’t observed.
Session topic: E-poster
Keyword(s): Chemotherapy toxicity
Type: Publication Only
Background
High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.
Aims
To evaluate late myelotoxicity of intensive modified program NHL-BFM-90 (mNHL-BFM-90) in adult poor-prognosis patients with diffuse large B-cell lymphoma (DLBCL).
Methods
Results of complex clinical, laboratory and instrumental examination, including cytological, histological and standard cytogenetic bone marrow study of 40 patients with DLBCL which received mNHL-BFM-90 protocol in the Hematology Research Center in the period since 2002 till 2009 years were analyzed. Group consisted of 20 men, 20 women, median age – 57 (31-76) years at the time of survey. Comparison group included 19 patients (8 men and 11 women), median age – 70 (39-80) years at the time of survey, who received CHOP /R-CHOP-21 therapy. Median follow-up after completion of treatment - 6 years. Results of study of bone marrow were analyzed before chemotherapy and after 5-10 years after treatment. Cellularity of bone marrow, the amount of erythroid, granulocytic and megakaryocytic germs, signs of dysplasia, and dysplastic changes of stroma were determined by histologically and cytologically. Also performs standard cytogenetic bone marrow examination to identify karyological violations. As late myelotoxicity were considered signs of toxic damage of bone marrow, which appeared first time in late period after chemotherapy . Cases with initially presented and preserved after chemotherapy myelotoxicity signs, as well as presence and absence of baseline after chemotherapy – weren’t taken into account.
Results
Cytopenia (with no signs of myelodysplasia and substitutive transfusions of blood components need) were detected in 52% of patients with high-dose group, 46% of cases are accounted for thrombocytopenia. Reduced cellularity of bone marrow in 15 (38%) patients, p = 0.02, reducing of erythroid and megakaryocytic germs in 13 (33%), p =0.01, and 19 (48%), p = 0.009, respectively, stroma changes in 17 (43%) patients, p = 0.02, were revealed like signs of late myelotoxicity in patients after high-dose chemotherapy for mNHL-BFM-90 program.Standard cytogenetic study of bone marrow was performed for first six patients, all had a normal karyotype, without any karyological abnormalities, therefore further study wasn’t performed.
Conclusion
Long-term myelotoxicity of high-dose program mNHL-BFM-90 exceeds significantly toxicity of standard therapy CHOP / R-CHOP-21. However, myelodysplastic syndromes or cytopenia requiring transfusions of blood components wasn’t observed.
Session topic: E-poster
Keyword(s): Chemotherapy toxicity
Abstract: PB1738
Type: Publication Only
Background
High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.
Aims
To evaluate late myelotoxicity of intensive modified program NHL-BFM-90 (mNHL-BFM-90) in adult poor-prognosis patients with diffuse large B-cell lymphoma (DLBCL).
Methods
Results of complex clinical, laboratory and instrumental examination, including cytological, histological and standard cytogenetic bone marrow study of 40 patients with DLBCL which received mNHL-BFM-90 protocol in the Hematology Research Center in the period since 2002 till 2009 years were analyzed. Group consisted of 20 men, 20 women, median age – 57 (31-76) years at the time of survey. Comparison group included 19 patients (8 men and 11 women), median age – 70 (39-80) years at the time of survey, who received CHOP /R-CHOP-21 therapy. Median follow-up after completion of treatment - 6 years. Results of study of bone marrow were analyzed before chemotherapy and after 5-10 years after treatment. Cellularity of bone marrow, the amount of erythroid, granulocytic and megakaryocytic germs, signs of dysplasia, and dysplastic changes of stroma were determined by histologically and cytologically. Also performs standard cytogenetic bone marrow examination to identify karyological violations. As late myelotoxicity were considered signs of toxic damage of bone marrow, which appeared first time in late period after chemotherapy . Cases with initially presented and preserved after chemotherapy myelotoxicity signs, as well as presence and absence of baseline after chemotherapy – weren’t taken into account.
Results
Cytopenia (with no signs of myelodysplasia and substitutive transfusions of blood components need) were detected in 52% of patients with high-dose group, 46% of cases are accounted for thrombocytopenia. Reduced cellularity of bone marrow in 15 (38%) patients, p = 0.02, reducing of erythroid and megakaryocytic germs in 13 (33%), p =0.01, and 19 (48%), p = 0.009, respectively, stroma changes in 17 (43%) patients, p = 0.02, were revealed like signs of late myelotoxicity in patients after high-dose chemotherapy for mNHL-BFM-90 program.Standard cytogenetic study of bone marrow was performed for first six patients, all had a normal karyotype, without any karyological abnormalities, therefore further study wasn’t performed.
Conclusion
Long-term myelotoxicity of high-dose program mNHL-BFM-90 exceeds significantly toxicity of standard therapy CHOP / R-CHOP-21. However, myelodysplastic syndromes or cytopenia requiring transfusions of blood components wasn’t observed.
Session topic: E-poster
Keyword(s): Chemotherapy toxicity
Type: Publication Only
Background
High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.High dose chemotherapy showed to be more effective compared with standart dose therapy in DLBCLpatients with poor prognosis, but late myelotoxicity wasn't estimated enough.
Aims
To evaluate late myelotoxicity of intensive modified program NHL-BFM-90 (mNHL-BFM-90) in adult poor-prognosis patients with diffuse large B-cell lymphoma (DLBCL).
Methods
Results of complex clinical, laboratory and instrumental examination, including cytological, histological and standard cytogenetic bone marrow study of 40 patients with DLBCL which received mNHL-BFM-90 protocol in the Hematology Research Center in the period since 2002 till 2009 years were analyzed. Group consisted of 20 men, 20 women, median age – 57 (31-76) years at the time of survey. Comparison group included 19 patients (8 men and 11 women), median age – 70 (39-80) years at the time of survey, who received CHOP /R-CHOP-21 therapy. Median follow-up after completion of treatment - 6 years. Results of study of bone marrow were analyzed before chemotherapy and after 5-10 years after treatment. Cellularity of bone marrow, the amount of erythroid, granulocytic and megakaryocytic germs, signs of dysplasia, and dysplastic changes of stroma were determined by histologically and cytologically. Also performs standard cytogenetic bone marrow examination to identify karyological violations. As late myelotoxicity were considered signs of toxic damage of bone marrow, which appeared first time in late period after chemotherapy . Cases with initially presented and preserved after chemotherapy myelotoxicity signs, as well as presence and absence of baseline after chemotherapy – weren’t taken into account.
Results
Cytopenia (with no signs of myelodysplasia and substitutive transfusions of blood components need) were detected in 52% of patients with high-dose group, 46% of cases are accounted for thrombocytopenia. Reduced cellularity of bone marrow in 15 (38%) patients, p = 0.02, reducing of erythroid and megakaryocytic germs in 13 (33%), p =0.01, and 19 (48%), p = 0.009, respectively, stroma changes in 17 (43%) patients, p = 0.02, were revealed like signs of late myelotoxicity in patients after high-dose chemotherapy for mNHL-BFM-90 program.Standard cytogenetic study of bone marrow was performed for first six patients, all had a normal karyotype, without any karyological abnormalities, therefore further study wasn’t performed.
Conclusion
Long-term myelotoxicity of high-dose program mNHL-BFM-90 exceeds significantly toxicity of standard therapy CHOP / R-CHOP-21. However, myelodysplastic syndromes or cytopenia requiring transfusions of blood components wasn’t observed.
Session topic: E-poster
Keyword(s): Chemotherapy toxicity
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