Changing patterns of chemotherapy relative dose intensity and supportive care for aggressive B-cell non-Hodgkin lymphoma.
Maintaining high relative dose intensity (RDI) is associated with improved outcomes, especially in patients with aggressive B-cell non-Hodgkin lymphoma (NHL). To evaluate changes in practice, we examined RDI, chemotherapy treatment patterns, dose delays and reductions, neutropenia and related consequences, and supportive care in 500 patients with aggressive B-cell NHL treated between 2006-2009. We then compared the results to a previous study of patients treated between 1993-2001. Relative to the previous study, rituximab was a common addition to CHOP-21 (91% vs. 3%), more patients received an RDI ≥ 85% (68% vs. 52%), and fewer patients experienced dose reductions (21% vs. 35%), though incidences of dose delays were similar (26% vs. 23%). Incidences of febrile neutropenia (FN; 12% vs. 21%) and FN-related hospitalizations (10% vs. 16%) were lower. Finally, more patients received primary prophylaxis with colony-stimulating factors (75% vs. 12%). Together, these results illustrate evolving practice patterns for patients with aggressive B-cell NHL.
a Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.|d University of Washington , Seattle , WA , USA.
Gary H
GH
Lyman
b Duke University and Duke Cancer Institute , Durham , NC , USA.
Jeffrey
J
Crawford
c Amgen Inc. , Thousand Oaks , CA , USA.
Dianne
D
Tomita
c Amgen Inc. , Thousand Oaks , CA , USA.
Sadie
S
Whittaker
d University of Washington , Seattle , WA , USA.
David C
DC
Dale
Chemotherapy; granulocyte colony-stimulating factor; lymphoma; neutropenia; non-Hodgkin