Impact of relative dose intensity of R-CCOP regimen in elderly patients with diffuse large B-cell lymphoma in China

Gao, Hongye; Liu, Yanfei; Xu, Yanfeng; Mi, Lan; Zhang, Chen; Wang, Xiaopei; Song, Yuqin; Zhu, Jun; Liu, Weiping

doi:10.1016/j.jfma.2022.06.003

Cited by 1 publication

(6 citation statements)

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Section: Discussionmentioning

confidence: 89%

“…The R-CODP regimen is an alternative treatment approach and is widely used for generics in China. 15 To the best of our knowledge, our study is the first report to compare current clinical indices in Chinese generics treated with the R-CODP regimen. Apart from the commonly used AIC and C-index, we adopted the IDI as a novel prognostic parameter to support the finding: the E-IPI, as a simple and convenient prognostic index, seemed to have better performance in predicting 5-year mortality for this population.…”

Section: Discussionmentioning

confidence: 90%

“…Our previous study indicated that tolerance and identifying risk categories are critical for clinical decision-making in this population. 15 …”

Section: Discussionmentioning

confidence: 99%

“… 10 The liposomal doxorubicin combination regimen for patients with lymphoma has been evaluated in some research with special concerns 11–14 and is the most commonly used among older adults. 15 …”

Section: Introductionmentioning

confidence: 99%

“…10 The liposomal doxorubicin combination regimen for patients with lymphoma has been evaluated in some research with special concerns [11][12][13][14] and is the most commonly used among older adults. 15 Identifying patients' risk stratification is critical for treatment selection. There is no consensus regarding the risk stratification system for elderly patients with DLBCL.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Clinical Prognostic Indices in Elderly Patients with Diffuse Large B-Cell Lymphoma Treated with a Pegylated Liposomal Doxorubicin Combination Regimen in China

Gao¹,

Xu²,

Liu³

et al. 2022

CMAR

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Background There is no consensus regarding the risk stratification scores for elderly patients with diffuse large B-cell lymphoma (DLBCL). We aimed to compare the prognostic predictive ability of the current clinical scoring indices in DLBCL elderly patients treated with the R-CODP regimen (rituximab, cyclophosphamide, pegylated liposomal doxorubicin, vincristine, and prednisone). Methods We retrospectively collected the data of elderly DLBCL patients who received the R-CODP regimen as the first-line treatment. The efficacy of the regimen was evaluated. The Akaike information criteria (AIC), concordance index (C-index), and integrated discrimination improvement (IDI) were used to assess the fitness and prognostic performance of the current clinical prognostic indices. Results In the total of 158 patients enrolled, the median follow-up time was 6.7 years (95% CI: 6.3–7.9), and the 5-year OS was 52.8% (95% CI: 45.5%–61.2%). The International Prognostic Index (IPI), National Comprehensive Cancer Network-IPI (NCCN-IPI), and Elderly International Prognostic Index (E-IPI) were all significantly associated with OS (P < 0.001 for all). However, no significance was observed in 5-year OS in the low- vs low-intermediate-risk groups for IPI (P = 0.377), NCCN-IPI (P = 0.238), and E-IPI (P = 0.080). Compared with the IPI and NCCN-IPI, the E-IPI had the lowest AIC value of 747.5 and the highest C-index of 0.692. For predicting 5-year mortality, the E-IPI showed better performance (AUC: 0.715 for E-IPI vs 0.676 for IPI, P = 0.036), with the IDI of 6.29% (95% CI: 3.71%-8.88%, P < 0.001) and 4.80% (95% CI: 1.32%-8.28%, P = 0.007) compared to the IPI and NCCN-IPI, respectively. Conclusion The E-IPI might be a better prognostic prediction model in Chinese DLBCL generics treated with R-CODP for predicting 5-year mortality. However, the IPI, NCCN-IPI, and E-IPI did not seem to be able to distinguish patients with a favorable prognosis well.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 90%

“…Our previous study indicated that tolerance and identifying risk categories are critical for clinical decision-making in this population. 15 …”

Section: Discussionmentioning

confidence: 99%