Long-term results of pirarubicin versus doxorubicin in combination chemotherapy for aggressive non-Hodgkin’s lymphoma: single center, 15-year experience

Abstract

Pirarubicin is an analog of doxorubicin. Few studies have compared the long-term outcomes of patients receiving pirarubicin-based THP-COP and doxorubicin-based CHOP in the treatment of non-Hodgkin's lymphoma (NHL). We retrospectively compared the efficacy and safety of these two regimens in 459 previously untreated aggressive NHL patients admitted to Sun Yat-Sen University Cancer Center from 1987 to 2003. For initial treatment, 205 patients received the THP-COP regimen, and 254 patients received the CHOP regimen. The patients' characteristics were well balanced. The groups did not differ in the complete remission rate (THP-COP, 57.1% vs. CHOP, 57.0%; P = 0.998) or response rate (THP-COP, 82.9% vs. CHOP, 81.5%; P = 0.691). At a median follow-up of 95.7 months, the 8-year survival rates were also similar (overall survival: THP-COP, 55.8% vs. CHOP, 56.7%; progression-free survival: THP-COP, 47.3% vs. CHOP, 43.5%; lymphoma-specific survival: THP-COP, 51.2% vs. CHOP, 48.5%). The THP-COP group had fewer cases of alopecia (P < 0.001) and gastrointestinal toxicities (P = 0.015). A tendency toward decreased arrhythmia (P = 0.075), especially in elderly patients (P = 0.030), was found. In combination chemotherapy for aggressive NHL, pirarubicin has comparable efficacy to doxorubicin and has a lower incidence of alopecia, gastrointestinal toxicities, and arrhythmia. Further studies are warranted to confirm these results.

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

“…59 Pirarubicin, when evaluated in adults with non-Hodgkin lymphoma, was marginally less cardiotoxic than doxorubicin, with the risk of arrhythmia being 9% versus 14%, respectively. 60 However, in that same study, both agents were associated with a similar risk of ischemic cardiac injury.…”

Improved treatment results of children with B‐cell non‐Hodgkin lymphoma: A report from the Japanese Pediatric Leukemia/Lymphoma Study Group B‐NHL03 study

“…To reduce the risk of cardiotoxicity, we employed THP-adriamycin (pirarubicin) instead of ADR. Pirarubicin is a derivative of ADR with reportedly less cardiotoxicity in adults [19][20][21][22][23][24]. Recently, we have reported that no significant cardiac dysfunction was detected in long-term survivors of children with acute lymphoblastic leukemia who received THP treatment [25][26][27].…”

3A Comparison between R-THP-COP and R-CHOP Regimens for the Treatment of Diffuse Large B-cell Lymphoma in Old Patients: A Single-institution Analysis

“…Zhai et al found that the long-term outcomes of aggressive NHL patients receiving the THP-COP regimen were similar to those of patients receiving the CHOP regimen ( 28 ). Furthermore, the THP-COP regimen has been recently shown to be effective for treating not only patients with DLBCL but also those with peripheral T-cell lymphoma ( 29 ).…”