Abstract:
Objective To investigate the efficacy and safety of separated R-CHOP in older patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).
Methods A total of 137 patients aged 65-80 years newly diagnosed with DLBCL between April 2013 and September 2022 at The First Affiliated Hospital of Zhengzhou University were enrolled. The patients were assigned into separated R-CHOP, full-dose R-CHOP, and reduced R-CHOP-like groups based on their different chemotherapy regimens. All individuals were treated in 21-day cycles for 4–8 cycles. The short-term and long-term efficacies and adverse reactions of the treatments were compared among the three groups, and factors influencing progression-free survival (PFS) and overall survival (OS) were analyzed.
Results The overall response rates (ORR) of patients in the separated R-CHOP, full-dose R-CHOP, and reduced R-CHOP-like groups were 89.7%, 90.3%, and 86.1%, respectively, with no significant differences among them. The complete respond rate (CRR) of the separated R-CHOP group (64.1%) was significantly higher than that of the reduced R-CHOP-like group (33.3%) (P=0.008) but not significantly different from that of the full-dose R-CHOP group (66.1%). Survival curve analysis revealed no significant differences in PFS and OS between the separated and full-dose R-CHOP groups. Although the separated R-CHOP group showed improved PFS compared with the reduced R-CHOP-like group (P=0.036), there was no statistical difference in OS between these two groups. Multivariate analysis revealed that the international prognostic index (IPI) and separated R-CHOP had significant effects on PFS in patients with DLBCL (all P<0.05), whereas only IPI had a significant effect on OS (P<0.001). The incidence of leukopenia and grade 3-4 leukopenia in the separated R-CHOP group was significantly lower than that in the full-dose R-CHOP group (P=0.007, P=0.012), but there was no significant difference with the reduced R-CHOP-like group in this regard.
Conclusions In older patients with newly diagnosed DLBCL, separated R-CHOP showed good efficacy both in the short and long terms and had acceptable safety and tolerability profiles.