Relationships between chemotherapy, chemotherapy dose intensity and outcomes of follicular lymphoma in the immunochemotherapy era

A report from the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource

Kitsada Wudhikarn, Brian J. Smith, Anna M. Button, Thomas Matthew Habermann, Carrie A Thompson, Lori J. Rosenstein, Sergei I. Syrbu, George J. Weiner, James R Cerhan, Brian K. Link

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The optimal treatment of follicular lymphoma (FL) is not established. Rituximabs value potentially dilutes the impact of chemotherapy on FL. We reviewed 337 cases of FL treated initially with rituximab as monotherapy or with chemotherapy at the University of Iowa/Mayo Clinic from 2002 to 2009, investigating the association between chemotherapy delivery of cyclophosphamide or doxorubicin and survival. With median follow-up duration of 52.7 months, event-free survival (EFS) and overall survival (OS) were similar between the two groups, with a trend toward better EFS in the R-chemotherapy cohort (hazard ratio [HR] = 1.24, p = 0.28). In the R-chemotherapy group, increased total dose delivery and delivered dose intensity of doxorubicin were associated with improved EFS only in patients who did not receive R-maintenance (HR = 0.81; p = 0.02 and HR = 0.94; p = 0.04). Cyclophosphamide delivery was not associated with EFS. Thus, in the immunochemotherapy era, chemotherapy delivery strategy requires re-evaluation.

Original languageEnglish (US)
Pages (from-to)2365-2372
Number of pages8
JournalLeukemia and Lymphoma
Volume56
Issue number8
DOIs
StatePublished - Aug 3 2015

Fingerprint

Follicular Lymphoma
Molecular Epidemiology
Lymphoma
Drug Therapy
Disease-Free Survival
Research
Doxorubicin
Cyclophosphamide
Survival
Maintenance

Keywords

  • dose intensity
  • Follicular lymphoma
  • immunochemotherapy
  • treatment delivery

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "Relationships between chemotherapy, chemotherapy dose intensity and outcomes of follicular lymphoma in the immunochemotherapy era: A report from the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource",
abstract = "The optimal treatment of follicular lymphoma (FL) is not established. Rituximabs value potentially dilutes the impact of chemotherapy on FL. We reviewed 337 cases of FL treated initially with rituximab as monotherapy or with chemotherapy at the University of Iowa/Mayo Clinic from 2002 to 2009, investigating the association between chemotherapy delivery of cyclophosphamide or doxorubicin and survival. With median follow-up duration of 52.7 months, event-free survival (EFS) and overall survival (OS) were similar between the two groups, with a trend toward better EFS in the R-chemotherapy cohort (hazard ratio [HR] = 1.24, p = 0.28). In the R-chemotherapy group, increased total dose delivery and delivered dose intensity of doxorubicin were associated with improved EFS only in patients who did not receive R-maintenance (HR = 0.81; p = 0.02 and HR = 0.94; p = 0.04). Cyclophosphamide delivery was not associated with EFS. Thus, in the immunochemotherapy era, chemotherapy delivery strategy requires re-evaluation.",
keywords = "dose intensity, Follicular lymphoma, immunochemotherapy, treatment delivery",
author = "Kitsada Wudhikarn and Smith, {Brian J.} and Button, {Anna M.} and Habermann, {Thomas Matthew} and Thompson, {Carrie A} and Rosenstein, {Lori J.} and Syrbu, {Sergei I.} and Weiner, {George J.} and Cerhan, {James R} and Link, {Brian K.}",
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T2 - A report from the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource

AU - Wudhikarn, Kitsada

AU - Smith, Brian J.

AU - Button, Anna M.

AU - Habermann, Thomas Matthew

AU - Thompson, Carrie A

AU - Rosenstein, Lori J.

AU - Syrbu, Sergei I.

AU - Weiner, George J.

AU - Cerhan, James R

AU - Link, Brian K.

PY - 2015/8/3

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N2 - The optimal treatment of follicular lymphoma (FL) is not established. Rituximabs value potentially dilutes the impact of chemotherapy on FL. We reviewed 337 cases of FL treated initially with rituximab as monotherapy or with chemotherapy at the University of Iowa/Mayo Clinic from 2002 to 2009, investigating the association between chemotherapy delivery of cyclophosphamide or doxorubicin and survival. With median follow-up duration of 52.7 months, event-free survival (EFS) and overall survival (OS) were similar between the two groups, with a trend toward better EFS in the R-chemotherapy cohort (hazard ratio [HR] = 1.24, p = 0.28). In the R-chemotherapy group, increased total dose delivery and delivered dose intensity of doxorubicin were associated with improved EFS only in patients who did not receive R-maintenance (HR = 0.81; p = 0.02 and HR = 0.94; p = 0.04). Cyclophosphamide delivery was not associated with EFS. Thus, in the immunochemotherapy era, chemotherapy delivery strategy requires re-evaluation.

AB - The optimal treatment of follicular lymphoma (FL) is not established. Rituximabs value potentially dilutes the impact of chemotherapy on FL. We reviewed 337 cases of FL treated initially with rituximab as monotherapy or with chemotherapy at the University of Iowa/Mayo Clinic from 2002 to 2009, investigating the association between chemotherapy delivery of cyclophosphamide or doxorubicin and survival. With median follow-up duration of 52.7 months, event-free survival (EFS) and overall survival (OS) were similar between the two groups, with a trend toward better EFS in the R-chemotherapy cohort (hazard ratio [HR] = 1.24, p = 0.28). In the R-chemotherapy group, increased total dose delivery and delivered dose intensity of doxorubicin were associated with improved EFS only in patients who did not receive R-maintenance (HR = 0.81; p = 0.02 and HR = 0.94; p = 0.04). Cyclophosphamide delivery was not associated with EFS. Thus, in the immunochemotherapy era, chemotherapy delivery strategy requires re-evaluation.

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