Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases
Obinutuzumab (G) has become part of front-line treatment of follicular lymphoma (FL) based on results of a large randomized study. Data on patients treated outside of clinical trials are lacking. We have retrospectively investigated efficacy and safety of G-based immunochemotherapy regimens in 114 p...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | HemaSphere |
| Online Access: | http://journals.lww.com/10.1097/HS9.0000000000000807 |
| _version_ | 1797280984827166720 |
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| author | Davor Galusic Sandra Basic-Kinda Andela Pijuk Vibor Milunovic Barbara Dreta Neven Franjic Bozena Coha Jasminka Sincic-Petricevic Petar Gacina Vlatko Pejsa Marko Lucijanic Igor Aurer |
| author_facet | Davor Galusic Sandra Basic-Kinda Andela Pijuk Vibor Milunovic Barbara Dreta Neven Franjic Bozena Coha Jasminka Sincic-Petricevic Petar Gacina Vlatko Pejsa Marko Lucijanic Igor Aurer |
| author_sort | Davor Galusic |
| collection | DOAJ |
| description | Obinutuzumab (G) has become part of front-line treatment of follicular lymphoma (FL) based on results of a large randomized study. Data on patients treated outside of clinical trials are lacking. We have retrospectively investigated efficacy and safety of G-based immunochemotherapy regimens in 114 patients treated in a real-life setting during a period of 2 years, largely coinciding with the COVID-19 pandemic. The response rate was 93.8%; 18-months overall (OS) and progression-free survival (PFS) were 88% and 84%, respectively. Patients treated with G-cyclophosphamide, vincristine and glucocorticoid + doxorubicine (CHOP) had statistically significantly superior OS and PFS compared to patients treated with G-bendamustine (G-B) (P = 0.002 and P = 0.006, respectively) due to an increase in lethal infections, most notably COVID-19, in the latter group. A total of 12 patients died during follow-up; 9 of 61 treated with G-B, 1 of 49 treated with G-CHOP and 2 of 4 treated with G-cyclophosphamide, vincristine and glucocorticoid (CVP). SARS-CoV-2 infection was diagnosed in 20 (17.5%) patients. All of the 7 treated with G-CHOP recovered, while 4 of 12 treated with G-B died. Immunoglobulin levels and severity of neutropenia were similar between the groups. In multivariate analysis, G-B in comparison to G-CHOP was an independent prognostic factor (P = 0.044, hazard ratio = 9.81) after adjustment for age, sex and Follicular Lymphoma International Prognostic Index (FLIPI). Based on our experience G has excellent antilymphoma activity in patients receiving front-line treatment for FL in real-life setting, but during the COVID-19 pandemic, it should be preferentially combined with CHOP, at least in patients younger than 65. |
| first_indexed | 2024-03-07T16:49:00Z |
| format | Article |
| id | doaj.art-488124ea74b64cb9b4bf303d49492770 |
| institution | Directory Open Access Journal |
| issn | 2572-9241 |
| language | English |
| last_indexed | 2024-03-07T16:49:00Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | HemaSphere |
| spelling | doaj.art-488124ea74b64cb9b4bf303d494927702024-03-03T05:47:29ZengWileyHemaSphere2572-92412022-12-01612e80710.1097/HS9.0000000000000807202212000-00006Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic DiseasesDavor Galusic0Sandra Basic-Kinda1Andela Pijuk2Vibor Milunovic3Barbara Dreta4Neven Franjic5Bozena Coha6Jasminka Sincic-Petricevic7Petar Gacina8Vlatko Pejsa9Marko Lucijanic10Igor Aurer111 Division of Hematology, Department of Internal Medicine, University Hospital of Split, Croatia3 Division of Hematology, Department of Internal Medicine, University Hospital Centre Zagreb, Croatia1 Division of Hematology, Department of Internal Medicine, University Hospital of Split, Croatia4 Division of Hematology, Department of Internal Medicine, University Hospital Merkur, Zagreb, Croatia3 Division of Hematology, Department of Internal Medicine, University Hospital Centre Zagreb, Croatia5 Division of Hematology, Department of Internal Medicine, University Hospital Centre Rijeka, Croatia6 Department of Internal Medicine, Dr. “Josip Bencevic” General Hospital, Slavonski Brod, Croatia7 Division of Hematology, Department of Internal Medicine, University Hospital Centre Osijek, Croatia8 Division of Hematology, Department of Internal Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia9 Division of Hematology, Department of Internal Medicine, University Hospital Dubrava, Zagreb, Croatia9 Division of Hematology, Department of Internal Medicine, University Hospital Dubrava, Zagreb, Croatia4 Division of Hematology, Department of Internal Medicine, University Hospital Merkur, Zagreb, CroatiaObinutuzumab (G) has become part of front-line treatment of follicular lymphoma (FL) based on results of a large randomized study. Data on patients treated outside of clinical trials are lacking. We have retrospectively investigated efficacy and safety of G-based immunochemotherapy regimens in 114 patients treated in a real-life setting during a period of 2 years, largely coinciding with the COVID-19 pandemic. The response rate was 93.8%; 18-months overall (OS) and progression-free survival (PFS) were 88% and 84%, respectively. Patients treated with G-cyclophosphamide, vincristine and glucocorticoid + doxorubicine (CHOP) had statistically significantly superior OS and PFS compared to patients treated with G-bendamustine (G-B) (P = 0.002 and P = 0.006, respectively) due to an increase in lethal infections, most notably COVID-19, in the latter group. A total of 12 patients died during follow-up; 9 of 61 treated with G-B, 1 of 49 treated with G-CHOP and 2 of 4 treated with G-cyclophosphamide, vincristine and glucocorticoid (CVP). SARS-CoV-2 infection was diagnosed in 20 (17.5%) patients. All of the 7 treated with G-CHOP recovered, while 4 of 12 treated with G-B died. Immunoglobulin levels and severity of neutropenia were similar between the groups. In multivariate analysis, G-B in comparison to G-CHOP was an independent prognostic factor (P = 0.044, hazard ratio = 9.81) after adjustment for age, sex and Follicular Lymphoma International Prognostic Index (FLIPI). Based on our experience G has excellent antilymphoma activity in patients receiving front-line treatment for FL in real-life setting, but during the COVID-19 pandemic, it should be preferentially combined with CHOP, at least in patients younger than 65.http://journals.lww.com/10.1097/HS9.0000000000000807 |
| spellingShingle | Davor Galusic Sandra Basic-Kinda Andela Pijuk Vibor Milunovic Barbara Dreta Neven Franjic Bozena Coha Jasminka Sincic-Petricevic Petar Gacina Vlatko Pejsa Marko Lucijanic Igor Aurer Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases HemaSphere |
| title | Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases |
| title_full | Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases |
| title_fullStr | Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases |
| title_full_unstemmed | Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases |
| title_short | Efficacy and Safety of Obinutuzumab-chemotherapy Combinations in Front-line Treatment of Follicular Non-Hodgkin Lymphoma During the COVID-19 Pandemic: A Study of KROHEM, the Croatian Cooperative Group for Hematologic Diseases |
| title_sort | efficacy and safety of obinutuzumab chemotherapy combinations in front line treatment of follicular non hodgkin lymphoma during the covid 19 pandemic a study of krohem the croatian cooperative group for hematologic diseases |
| url | http://journals.lww.com/10.1097/HS9.0000000000000807 |
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