- Title
- A phase III randomized trial of high-dose CEOP + filgrastim versus standard-dose CEOP in patients with non-Hodgkin lymphoma: 10-year follow-up data: Australasian Leukaemia and Lymphoma Group (ALLG) NHL07 trial
- Creator
- Hertzberg, Mark; Matthews, Jane Palfrey; Abdi, Ehtesham; Green, Michael; Bonaventura, Anthony; Marlton, Paula; Cannell, Paul; Wolf, Max; Stone, Janey Malka; Dubosq, Ming-Celine; Grigg, Andrew; Ellis, David; Benson, Warwick; Browett, Peter; Horvath, Noemi; Januszewicz, Henry
- Relation
- American Journal of Hematology Vol. 89, Issue 5, p. 536-541
- Publisher Link
- http://dx.doi.org/10.1002/ajh.23684
- Publisher
- Wiley-Blackwell Publishing Ltd
- Resource Type
- journal article
- Date
- 2014
- Description
- Increasing dose intensity (DI) of chemotherapy for patients with aggressive non-Hodgkin lymphoma (NHL) may improve outcomes at the cost of increased toxicity. This issue was addressed in a randomized trial aiming to double the DI of myelosuppressive drugs. Between 1994 and 1999, 250 patients with previously untreated aggressive NHL were randomized to treatment with six cycles of 3-weekly standard (s) or intensive (i) chemotherapy: s-CEOP–cyclophosphamide 750, epirubicin 75, vincristine 1.4 mg/m2 all on day 1, and prednisolone 100 mg days 1–5; i-CEOP–cyclophosphamide 1,500, epirubicin 150, vincristine 1.4 mg/m2 all on day 1, and prednisolone 100 mg days 1–5. Primary endpoint was 5-year overall survival (OS). Relative to s-CEOP patients, i-CEOP patients achieved a 78% increase in the DI of cyclophosphamide and epirubicin. Despite this, there was no significant difference in any outcome: 5-year OS (56.7% i-CEOP; 55.1% s-CEOP; P = 0.80), 5-year progression free survival (PFS; 41% i-CEOP; 43% s-CEOP; P = 0.73), 5-year time to progression (TTP; 44% i-CEOP; 47% s-CEOP; P = 0.72), or complete remission (CR) + unconfirmed CR (CRu) rates (53% i-CEOP; 59% s-CEOP; P = 0.64). Long-term follow up at 10 years also showed no significant differences in OS, PFS, or TTP. The i-CEOP arm had higher rates of febrile neutropenia (70 vs. 26%), hospitalisations, blood product utilisation, haematological and gastrointestinal toxicities, and lower quality of life scores during treatment, although without significant differences 6-month later. In the treatment of aggressive NHL in the prerituximab era, increasing DI did not result in improved outcomes, while at the same time lead to increased toxicity.
- Subject
- filgratism; non-Hodgkin lymphoma; chemotherapy; CEOP
- Identifier
- http://hdl.handle.net/1959.13/1293533
- Identifier
- uon:18630
- Identifier
- ISSN:0361-8609
- Language
- eng
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