Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma
Abstract Context Treatment-related toxicities in DLBCL (diffuse large B cell lymphoma) patients are higher in the initial phase of treatment (first cycle effect). Implementation of pre-phase treatment before definitive chemotherapy had been shown to alleviate some of these side-effects in a non-rand...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-05-01
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| Series: | Journal of the Egyptian National Cancer Institute |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43046-022-00116-5 |
| _version_ | 1828796315782348800 |
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| author | A. H. Rudresha Syed Adil Hassan A. Sreevalli D. Lokanatha M. C. Suresh Babu K. N. Lokesh L. K. Rajeev Smitha Saldanha Antony G. F. Thottian Kanika Sharma Linu Abraham Jacob |
| author_facet | A. H. Rudresha Syed Adil Hassan A. Sreevalli D. Lokanatha M. C. Suresh Babu K. N. Lokesh L. K. Rajeev Smitha Saldanha Antony G. F. Thottian Kanika Sharma Linu Abraham Jacob |
| author_sort | A. H. Rudresha |
| collection | DOAJ |
| description | Abstract Context Treatment-related toxicities in DLBCL (diffuse large B cell lymphoma) patients are higher in the initial phase of treatment (first cycle effect). Implementation of pre-phase treatment before definitive chemotherapy had been shown to alleviate some of these side-effects in a non-randomized study conducted earlier in our institute (Lakshmaiah et. al., Eur J Haematol 100:644-8, 2018). Aims This study was aimed at validating the role of pre-phase treatment in newly diagnosed DLBCL patients. Settings and design All newly diagnosed patients with DLBCL above the age of 18 years were evaluated for eligibility and prospectively enrolled. A single-arm prospective study was conducted at the Department of Medical Oncology, in our institute from July 2015 to December 2019. Methods and material Patients received vincristine and prednisolone as pre-phase treatment for 7 days after which definitive chemotherapy was instituted on day 1. They were followed up for 30 days post-first cycle chemotherapy. Statistical analysis used Paired Student’s t tests and Wilcoxon signed-ranks test were used for comparison of various clinical variables as appropriate. P value of less than 0.05 was considered significant. Results Among the 180 patients who were included in study, performance status improvement was noted in significant number of patients (p < 0.001). 38.4% achieved an ECOG (Eastern Cooperative Oncology Group) performance status of 0 post-pre-phase therapy. Febrile neutropenia was observed in 12.8% in the present cohort as compared to the historical non-pre-phase cohort (34%). Conclusions Pre-phase therapy significantly improves the performance status and diminishes neutropenia rates in DLBCL patients. |
| first_indexed | 2024-12-12T04:19:25Z |
| format | Article |
| id | doaj.art-c902ba2e39e84dd6b0fcdcef06ac5223 |
| institution | Directory Open Access Journal |
| issn | 2589-0409 |
| language | English |
| last_indexed | 2024-12-12T04:19:25Z |
| publishDate | 2022-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian National Cancer Institute |
| spelling | doaj.art-c902ba2e39e84dd6b0fcdcef06ac52232022-12-22T00:38:21ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092022-05-013411510.1186/s43046-022-00116-5Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphomaA. H. Rudresha0Syed Adil Hassan1A. Sreevalli2D. Lokanatha3M. C. Suresh Babu4K. N. Lokesh5L. K. Rajeev6Smitha Saldanha7Antony G. F. Thottian8Kanika Sharma9Linu Abraham Jacob10Department of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyDepartment of Medical Oncology, Kidwai Memorial Institute of OncologyAbstract Context Treatment-related toxicities in DLBCL (diffuse large B cell lymphoma) patients are higher in the initial phase of treatment (first cycle effect). Implementation of pre-phase treatment before definitive chemotherapy had been shown to alleviate some of these side-effects in a non-randomized study conducted earlier in our institute (Lakshmaiah et. al., Eur J Haematol 100:644-8, 2018). Aims This study was aimed at validating the role of pre-phase treatment in newly diagnosed DLBCL patients. Settings and design All newly diagnosed patients with DLBCL above the age of 18 years were evaluated for eligibility and prospectively enrolled. A single-arm prospective study was conducted at the Department of Medical Oncology, in our institute from July 2015 to December 2019. Methods and material Patients received vincristine and prednisolone as pre-phase treatment for 7 days after which definitive chemotherapy was instituted on day 1. They were followed up for 30 days post-first cycle chemotherapy. Statistical analysis used Paired Student’s t tests and Wilcoxon signed-ranks test were used for comparison of various clinical variables as appropriate. P value of less than 0.05 was considered significant. Results Among the 180 patients who were included in study, performance status improvement was noted in significant number of patients (p < 0.001). 38.4% achieved an ECOG (Eastern Cooperative Oncology Group) performance status of 0 post-pre-phase therapy. Febrile neutropenia was observed in 12.8% in the present cohort as compared to the historical non-pre-phase cohort (34%). Conclusions Pre-phase therapy significantly improves the performance status and diminishes neutropenia rates in DLBCL patients.https://doi.org/10.1186/s43046-022-00116-5Pre-phaseFirst cycle effectDLBCL |
| spellingShingle | A. H. Rudresha Syed Adil Hassan A. Sreevalli D. Lokanatha M. C. Suresh Babu K. N. Lokesh L. K. Rajeev Smitha Saldanha Antony G. F. Thottian Kanika Sharma Linu Abraham Jacob Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma Journal of the Egyptian National Cancer Institute Pre-phase First cycle effect DLBCL |
| title | Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma |
| title_full | Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma |
| title_fullStr | Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma |
| title_full_unstemmed | Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma |
| title_short | Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma |
| title_sort | pre phase strategy to mitigate first cycle effect in diffuse large b cell lymphoma |
| topic | Pre-phase First cycle effect DLBCL |
| url | https://doi.org/10.1186/s43046-022-00116-5 |
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