Skip to main content

Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study.

Publication ,  Journal Article
Lyman, GH; Dale, DC; Friedberg, J; Crawford, J; Fisher, RI
Published in: J Clin Oncol
November 1, 2004

PURPOSE: To assess the incidence of and risk factors for reduced relative dose-intensity (RDI) in patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma (NHL). METHODS: A nationwide survey was conducted of 567 oncology practices with data extracted from the records of 4,522 patients with aggressive NHL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP); CHOP-rituximab (CHOP-R); or cyclophosphamide, mitoxantrone, vincristine, and prednisone (CNOP). The primary outcome was the average RDI for each regimen based on both planned and reference standards. Other assessments included the incidence of febrile neutropenia and patterns of colony-stimulating factor (CSF) use, as well as the average RDI in high-risk subgroups. RESULTS: Dose reductions > or = 15% occurred in 40% of patients and treatment delays > or = 7 days occurred in 24% of patients, resulting in 53% and 48% of patients receiving an RDI less than 85% of the minimum six-cycle and National Comprehensive Cancer Network guideline standards, respectively. Reduced RDI was more prevalent in older patients, with 60% of patients older than 60 years receiving RDI less than 85%. Multivariate analysis identified several independent predictors for reduced RDI, including age older than 60 years, advanced disease stage, poor performance status, and no prophylactic CSF use. Age was no longer a significant risk factor in patients who received prophylactic CSF. CONCLUSION: Patients with aggressive and potentially curable NHL treated with CHOP, CHOP-R, or CNOP frequently receive reduced RDI. Predictive models based on the risk factors identified for reduced RDI should enable the targeted use of appropriate supportive care, facilitating the delivery of full chemotherapy doses on schedule.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1, 2004

Volume

22

Issue

21

Start / End Page

4302 / 4311

Location

United States

Related Subject Headings

  • Vincristine
  • United States
  • Treatment Outcome
  • Rituximab
  • Risk Factors
  • Retrospective Studies
  • Prednisone
  • Prednisolone
  • Oncology & Carcinogenesis
  • Mitoxantrone
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lyman, G. H., Dale, D. C., Friedberg, J., Crawford, J., & Fisher, R. I. (2004). Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study. J Clin Oncol, 22(21), 4302–4311. https://doi.org/10.1200/JCO.2004.03.213
Lyman, Gary H., David C. Dale, Jonathan Friedberg, Jeffrey Crawford, and Richard I. Fisher. “Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study.J Clin Oncol 22, no. 21 (November 1, 2004): 4302–11. https://doi.org/10.1200/JCO.2004.03.213.
Lyman GH, Dale DC, Friedberg J, Crawford J, Fisher RI. Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study. J Clin Oncol. 2004 Nov 1;22(21):4302–11.
Lyman, Gary H., et al. “Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study.J Clin Oncol, vol. 22, no. 21, Nov. 2004, pp. 4302–11. Pubmed, doi:10.1200/JCO.2004.03.213.
Lyman GH, Dale DC, Friedberg J, Crawford J, Fisher RI. Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study. J Clin Oncol. 2004 Nov 1;22(21):4302–4311.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1, 2004

Volume

22

Issue

21

Start / End Page

4302 / 4311

Location

United States

Related Subject Headings

  • Vincristine
  • United States
  • Treatment Outcome
  • Rituximab
  • Risk Factors
  • Retrospective Studies
  • Prednisone
  • Prednisolone
  • Oncology & Carcinogenesis
  • Mitoxantrone