Factors associated with early termination of CHOP therapy and the impact on survival among patients with chemosensitive intermediate-grade non-Hodgkin's lymphoma

Elizabeth A Chrischilles; Brian K Link; Shane D Scott; David J Delgado; Moshe Fridman

doi:10.1177/107327480301000507

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Factors associated with early termination of CHOP therapy and the impact on survival among patients with chemosensitive intermediate-grade non-Hodgkin's lymphoma

Journal article

Open access

Peer reviewed

Factors associated with early termination of CHOP therapy and the impact on survival among patients with chemosensitive intermediate-grade non-Hodgkin's lymphoma

Elizabeth A Chrischilles, Brian K Link, Shane D Scott, David J Delgado and Moshe Fridman

Cancer control, Vol.10(5), pp.396-403

09/2003

DOI: 10.1177/107327480301000507

PMID: 14581895

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Abstract

Six to eight cycles of CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) is standard for intermediate-grade non-Hodgkin's lymphoma (NHL) but is associated with toxicity that may cause premature termination of therapy. We studied factors associated with premature termination of CHOP therapy (receiving fewer than 6 cycles) and the relationship of premature termination with survival. Subjects consisted of a population-based sample of Iowa residents with intermediate-grade NHL who were planned to receive > or = 6 or more cycles of CHOP and who were chemosensitive (ie, achieved a documented partial or complete response to CHOP). In a comparison with patients 18-59 years of age, the odds of premature termination of CHOP therapy was 2.6 (95% CI, 0.7-9.2) for those aged 60-74 and 6.2 (95% CI, 1.7-23.3) for those aged > or = 75. Patients with cycle 1 febrile neutropenia hospitalization (FNH) were 4.4 times (95% CI, 1.4-13.8) more likely to terminate CHOP prematurely than those without cycle 1 FNH. Among patients aged 60-74, but not those aged > or = 75, premature termination appeared to be associated with decreased 5-year survival (hazard ratio [HR] = 6.0; 95% CI, 2.4-15.2) compared with those completing CHOP therapy (HR = 2.1; 95% CI, 1.0-4.2). Findings for overall survival were similar. First-cycle FNH and age > or = 60 years were associated with premature termination of CHOP therapy. The association of premature termination with survival among chemosensitive patients differed by age.

Cyclophosphamide - administration & dosage

Prednisone - administration & dosage

Antineoplastic Combined Chemotherapy Protocols - administration & dosage

Prednisone - adverse effects

Humans

Middle Aged

Risk Factors

Antineoplastic Combined Chemotherapy Protocols - adverse effects

Male

Survival Rate

Cyclophosphamide - adverse effects

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Adolescent

Vincristine - administration & dosage

Vincristine - adverse effects

Adult

Female

Aged

Lymphoma, Non-Hodgkin - mortality

Retrospective Studies

Doxorubicin - adverse effects

Doxorubicin - administration & dosage

Lymphoma, Non-Hodgkin - drug therapy

Details

Title: Subtitle: Factors associated with early termination of CHOP therapy and the impact on survival among patients with chemosensitive intermediate-grade non-Hodgkin's lymphoma
Creators: Elizabeth A Chrischilles - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City 52242, USA. chrischilles@uiowa.edu
Brian K Link
Shane D Scott
David J Delgado
Moshe Fridman
Resource Type: Journal article
Publication Details: Cancer control, Vol.10(5), pp.396-403
DOI: 10.1177/107327480301000507
PMID: 14581895
NLM abbreviation: Cancer Control
ISSN: 1073-2748
eISSN: 1526-2359
Publisher: United States
Language: English
Date published: 09/2003
Academic Unit: Pharmacy; Epidemiology; Internal Medicine
Record Identifier: 9983995143102771

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