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Survival of diffuse large cell lymphoma. A multivariate analysis including dose intensity variables
Author(s) -
Epelbaum Ron,
Faraggi David,
BenArie Yehudit,
BenShahar Menahem,
Haim Nissim,
Ron Yishai,
Robinson Eliezer,
Cohen Yoram
Publication year - 1990
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19900915)66:6<1124::aid-cncr2820660608>3.0.co;2-t
Subject(s) - medicine , vincristine , proportional hazards model , cyclophosphamide , univariate analysis , multivariate analysis , prednisone , chop , regimen , chemotherapy , gastroenterology , stage (stratigraphy) , survival analysis , lymphoma , oncology , biology , paleontology
Ninety‐five newly diagnosed patients with diffuse large cell lymphoma (DLCL) treated by cyclophosphamide (CTX), doxorubicin (ADM), vincristine (VCR), and prednisone (CHOP regimen) chemotherapy were evaluated for survival factors including dose intensity (DI). DI calculations were done for the initial cycles needed to achieve maximal response. The medians of the relative DI for CTX, ADM, and VCR were 0.9, 0.86, and 0.79, respectively. The median of the average relative DI (ARDI) was 0.83 (range, 0.28 to 1.14). The univariate analysis of potential prognostic variables showed that the following significantly decreased the survival rate: age older than 60 years ( P = 0.0005), Stage III to IV ( P = 0.02), male sex ( P = 0.03), and all four DI variables (CTX, ADM, VCR, and ARDI) less than the median ( P = 0.01 to 0.0001). A multivariate analysis by the stepwise proportional hazards model of Cox indicated that the factors predicting a poor prognosis were ARDI less than the median ( P = 0.0003) and age older than 60 years ( P = 0.02). A multivariate survival analysis of those who achieved complete remission showed ARDI less than the median ( P = 0.0003), CTX less than the median ( P = 0.02), and Stage III to IV ( P = 0.02) to be the most negative factors regarding survival. In conclusion, a high DI in the initial cycles of CHOP chemotherapy for DLCL has a significant positive impact on survival.