TY - JOUR
T1 - A multi-center analysis of the impact of DA-EPOCH-R dose-adjustment on clinical outcomes of patients with double/triple-hit lymphoma
AU - Cortese, Matthew J.
AU - Wei, Wei
AU - Cerdeña, Sebastian
AU - Watkins, Marcus P.
AU - Olson, Marissa
AU - Jodon, Gray
AU - Kaiser, Jeff
AU - Haverkos, Bradley
AU - Hughes, Mitchell E.
AU - Namoglu, Esin
AU - Grover, Natalie S.
AU - Snow, Anson
AU - Orellana-Noia, Victor
AU - Rainey, Magdalena
AU - Sohail, Mohammad
AU - Rudoni, Joslyn
AU - Portell, Craig
AU - Voorhees, Timothy
AU - Landsburg, Daniel J.
AU - Kamdar, Manali
AU - Kahl, Brad S.
AU - Hill, Brian T.
N1 - Funding Information:
Special thanks to our patients and their respective treatment teams at our collaborating institutions, including the Cleveland Clinic Taussig Cancer Institute, Barnes-Jewish Hospital at Washington University in St. Louis, the University of Colorado Cancer Center, the Abramson Cancer Center at the University of Pennsylvania, the Lineberger Comprehensive Cancer Center at the University of North Carolina, and the Division of Hematology/Oncology at the University of Virginia.
Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Patients with double- and triple-hit lymphomas (DHL/THL) have inferior outcomes with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), and higher-intensity regimens such as dose-adjusted (DA)-EPOCH-R are standard. Dose-intensification of DA-EPOCH-R is guided by hematologic toxicity, without conclusive benefit for DHL/THL patients. To determine if cumulative doses of DA-EPOCH-R or compliance with dose adjustment impacts survival, we retrospectively evaluated detailed clinical data from 109 adult (age ≥18 years) patients with DHL/THL treated with ≥4 cycles of induction DA-EPOCH-R from 2014 to 2019 at six centers. A comprehensive multivariate analysis was performed. Survival outcomes for the entire cohort were comparable to historical estimates for DHL/THL treated with this regimen (median follow-up 27.9 months). Overall survival (OS) and progression-free survival (PFS) were not significantly associated with cumulative chemotherapy dose, dose escalation, or compliance with dose adjustment. Heterogeneous dosing practices were observed. Prospective investigation is warranted to evaluate the practice of dose adjustment of R-EPOCH for patients with DHL/THL.
AB - Patients with double- and triple-hit lymphomas (DHL/THL) have inferior outcomes with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), and higher-intensity regimens such as dose-adjusted (DA)-EPOCH-R are standard. Dose-intensification of DA-EPOCH-R is guided by hematologic toxicity, without conclusive benefit for DHL/THL patients. To determine if cumulative doses of DA-EPOCH-R or compliance with dose adjustment impacts survival, we retrospectively evaluated detailed clinical data from 109 adult (age ≥18 years) patients with DHL/THL treated with ≥4 cycles of induction DA-EPOCH-R from 2014 to 2019 at six centers. A comprehensive multivariate analysis was performed. Survival outcomes for the entire cohort were comparable to historical estimates for DHL/THL treated with this regimen (median follow-up 27.9 months). Overall survival (OS) and progression-free survival (PFS) were not significantly associated with cumulative chemotherapy dose, dose escalation, or compliance with dose adjustment. Heterogeneous dosing practices were observed. Prospective investigation is warranted to evaluate the practice of dose adjustment of R-EPOCH for patients with DHL/THL.
KW - DA-EPOCH-R
KW - Double/triple-hit lymphomas
KW - chemoimmunotherapy
KW - chemotherapy
KW - high-grade B-cell lymphomas
KW - lymphoma
UR - http://www.scopus.com/inward/record.url?scp=85141419392&partnerID=8YFLogxK
U2 - 10.1080/10428194.2022.2140281
DO - 10.1080/10428194.2022.2140281
M3 - Article
C2 - 36323309
AN - SCOPUS:85141419392
SN - 1042-8194
VL - 64
SP - 107
EP - 118
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 1
ER -