title: Long-Term Follow-Up of a Phase II Trial of Six Cycles of Dose-Dense R-CHOP-14 for First-Line Treatment of Diffuse Large B-Cell Lymphoma in Young and Elderly Patients.
abstract: Rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 14 days seems to achieve better outcomes than R-CHOP every 21 days in diffuse large B-cell lymphoma (DLBCL) patients. Currently, the standard regimen is R-CHOP every 21 days.
  
  
  
  This is a phase II clinical trial of treatment with 6 cycles of R-CHOP-14 with pegfilgrastim support in 2 populations of previously untreated DLBCL patients aged ≥65 years (n = 73) or <65 years (n = 51) with low-risk International Prognostic Index scores (0-2).
  
  
  
  With a median follow-up of 63.7 months, the 5-year event-free survival rate was 53.8% in patients aged ≥65 years and 71.0% in patients aged <65 years. The 5-year overall survival rate was 71.4 and 89.8%, respectively. The complete remission rate was 69.9% for older and 80.4% for younger patients. The median relative dose intensity of cytotoxic drugs was 143.2% in the elderly and 149.1% in the young patients. Febrile neutropenia was the most common grade 3-4 adverse event, being higher in elderly patients (21.3 vs. 9.3%). Eight deaths (7 in elderly patients) were considered treatment related.
  
  
  
  In conclusion, the R-CHOP-14 regimen is feasible and very active, though it is more toxic in elderly patients mainly due to an increased incidence of infections. New strategies, such as new monoclonal antibodies or new targeted therapies, are needed to improve the outcomes of DLBCL patients.
authors.affiliation: Institut Catalx00E0; d'Oncologia, Hospital Duran i Reynals, IDIBELL, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: González-Barca
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Canales
authors.forename: Antonio
authors.initials: A
authors.lastname: Salar
authors.forename: Secundino
authors.initials: S
authors.lastname: Ferrer
authors.forename: Eva
authors.initials: E
authors.lastname: Domingo-Domenech
authors.forename: María-Jesús
authors.initials: MJ
authors.lastname: Vidal
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Joan
authors.initials: J
authors.lastname: Bargay
authors.forename: Santiago
authors.initials: S
authors.lastname: Gardella
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
authors.forename: Javier
authors.initials: J
authors.lastname: Briones
authors.forename: Javier
authors.initials: J
authors.lastname: García-Frade
authors.forename: Jose L
authors.initials: JL
authors.lastname: Bello
authors.forename: Jose J
authors.initials: JJ
authors.lastname: Sánchez-Blanco
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Peñalver
authors.forename: Jose Francisco
authors.initials: JF
authors.lastname: Tomás
authors.forename: Antonio
authors.initials: A
authors.lastname: Asensio
authors.forename: Andrés
authors.initials: A
authors.lastname: López
authors.forename: Dolores
authors.initials: D
authors.lastname: Caballero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008137:Longitudinal Studies; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology; D011092:Polyethylene Glycols; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012074:Remission Induction; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D000069585:Filgrastim; D011241:Prednisone