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Efficacy of a dose-intensified CHOP (Double-CHOP) regimen for peripheral T-cell lymphomas.

Abstract
Peripheral T-cell lymphomas (PTCLs) are a rare and heterogeneous group of non-Hodgkin lymphomas, often resulting in poor prognoses. The CHOP chemotherapy regimen, which includes cyclophosphamide, doxorubicin, vincristine and prednisone, has been used previously to treat other types of lymphomas. Here, we examined the efficacy and safety of a dose-intensified CHOP regimen (Double-CHOP), which was followed by autologous stem-cell transplantation (ASCT) or high-dose methotrexate (HDMTX), in PTCL patients. Twenty-eight PTCL patients, who received 3 courses of Double-CHOP at our institution, were retrospectively studied from 1996 to 2012. Patients with anaplastic lymphoma kinase-positive anaplastic large-cell lymphoma (ALK+-ALCL) were excluded from this study. The median age of patients was 58 years (range: 17-69). They had low-intermediate (n=11), high-intermediate (n=10) or high (n=7) risk according to the International Prognostic Index (IPI). The overall complete remission (CR) rate following Double-CHOP treatment was 68%. Of the CR patients, 10 successfully tolerated a consolidated high-dose chemotherapy followed by ASCT and 7 received HDMTX. A single case of treatment-related mortality was recorded during the study. On a median 31-month follow-up, the estimated 3- or 5-year overall survival (OS) rates were 68 or 63%, respectively, while 3- or 5-year relapse-free survival (RFS) rates after CR were 60 or 43%, respectively. Although this study included elderly and excluded low-risk IPI and ALK+-ALCL patients, OS results were superiorly favourable, indicating the efficacy of this Double-CHOP regimen. However, an effective treatment strategy for refractory or relapsing patients needs to be validated and established.
AuthorsNoriyoshi Iriyama, Hiromichi Takahashi, Yoshihiro Hatta, Katsuhiro Miura, Yujin Kobayashi, Daisuke Kurita, Yukio Hirabayashi, Atsuko Hojo, Hitomi Kodaira, Mai Yagi, Satomi Kiso, Yoshihito Uchino, Masaru Nakagawa, Machiko Kusuda, Sumiko Kobayashi, Akira Horikoshi, Yoshimasa Kura, Tetsuo Yamazaki, Umihiko Sawada, Jin Takeuchi
JournalOncology reports (Oncol Rep) Vol. 29 Issue 2 Pg. 805-11 (Feb 2013) ISSN: 1791-2431 [Electronic] Greece
PMID23166041 (Publication Type: Journal Article)
Chemical References
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone
  • Methotrexate
Topics
  • Adolescent
  • Adult
  • Aged
  • Anemia (chemically induced)
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
  • Combined Modality Therapy
  • Cyclophosphamide (administration & dosage, adverse effects)
  • Disease-Free Survival
  • Doxorubicin (administration & dosage, adverse effects)
  • Drug Administration Schedule
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymphoma, T-Cell, Peripheral (drug therapy, therapy)
  • Male
  • Methotrexate (administration & dosage)
  • Middle Aged
  • Neutropenia (chemically induced)
  • Prednisone (administration & dosage, adverse effects)
  • Retrospective Studies
  • Risk Factors
  • Stem Cell Transplantation
  • Survival Rate
  • Thrombocytopenia (chemically induced)
  • Transplantation, Autologous
  • Vincristine (administration & dosage, adverse effects)
  • Young Adult

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