Efficacy and safety of CHOP-B, MINE and GELOXD alternating regimens in the treatment of primary peripheral T-cell lymphoma: A single-center retrospective analysis
10.3781/j.issn.1000-7431.2019.33.179
- Author:
Bihua CHEN
1
Author Information
1. Department of Hematology and Lymphoma, Hunan Cancer Hospital/Affiliated Cancer Hospital, Xiangya School of Medicine
- Publication Type:Journal Article
- Keywords:
Antineoplastic combined chemotherapy protocols;
Drug-related side effects and adverse reactions;
Lymphoma;
Prognosis;
T-cell
- From:
Tumor
2019;39(8):658-667
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical efficacy and adverse effects of alternating triple therapy with CHOP-B, MINE and GELOXD in the treatment of primary peripheral T-cell lymphomas (PTCLs) by a single-center study. Methods: From January 2012 to December 2016, the pathological data of fifty-four patients with PTCLs admitted to Hunan Cancer Hospital were enrolled in this retrospective analysis.The last follow-up period was up to June 20, 2018. All patients underwent alternating triple therapy regimens with CHOP-B, MINE and GELOXD, and then the complete clinical data were collected. Survival was analyzed by Kaplan-Meier method. Multivariate COX analysis was performed to explore the related factors affecting prognosis. Results: Among 54 patients with PTCLs, twenty-six patients were diagnosed with peripheral T-cell lymph-non-specific lymphoma (PTCL-NOS), while there is one patient with angioimmunoblastic lymphoma, fifty patients with anaplastic lymphoma kinase positive anaplastic large cell lymphoma (ALK+ALCL), and twelve patients with ALK negtive ALCL (ALKALCL). The stage of EI-IV was demonstrated in 77.8% cases, the elevated lactate dehydrogenase (LDH) was observed in 40.7% of the patients, and 31.5% of the patients were in the lower risk group of prognostic index for PTCL-NOS (PIT) score. Following the initial therapy, 20 of 54 (37.0%) cases achieved complete remission, 22 (40.7%) achieved partial remission, 1 (1.9%) had stable disease, and 11 (20.4%) had disease progression. The objective remission rate (ORR) was 77.3%. The 3-year progression-free survival (PFS) and overall survival (OS) were 58.3% and 71.7%, respectively. The median PFS was 41.3 months, but the median OS was not achieved. Univariate analysis showed that age, bone marrow involvement, high body mass index (BMI), elevated LDH, PIT score, and clinical stage (El-IV)were associated with OS. Multivariate analysis showed PIT score ≥ 2(P < 0.001) and BMI ≥ 24 kg/m2 (P = 0.025) were the independent prognostic factor for the patients with PTCLs. Haemocytopenia was the predominant adverse effect. The incidence of degree 3-4 leukopenia in CHOP-B, MINE, GELOXD regimens was 4.6%, 10.1% and 17.5%, respectively; the incidence of degree 3-4 anemia was 4.6%, 5.1% and 0.9%, respectively; the incidence of degree 3-4 thrombocytopenia was 2.7%, 0.0% and 0.9%, respectively. Conclusion: The combination of CHOP-B, MINE and GELOXD regimens is efficacy and safety in the treatment of PTCLs, so it is worth popularizing in more cases.
