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Hiroi T, Hosoi H, Kuriyama K, Murata S, Morimoto M, Mushino T, Nishikawa A, Tamura S, Sonoki T. An evaluation based on relative treatment intensity in older patients treated with reduced-dose R-THP-COP therapy for diffuse large B-cell lymphoma: A multicenter retrospective cohort study. J Geriatr Oncol 2023; 14:101396. [PMID: 36328877 DOI: 10.1016/j.jgo.2022.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/14/2022] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The number of older patients with diffuse large B-cell lymphoma (DLBCL) is increasing. Although the standard treatment for newly diagnosed younger patients with DLBCL has been established, no consensus has been reached regarding the optimal chemotherapy intensity and regimen for older patients with DLBCL. In addition, no method for evaluating treatment intensity in retrospective studies when different numbers of chemotherapy courses are administered has been elucidated. MATERIALS AND METHODS A multicenter retrospective analysis was conducted to evaluate the outcomes of a reduced-dose R-THP-COP regimen, which included 30 mg/m2 of pirarubicin, in 54 patients with DLBCL who were aged ≥75. To assess treatment intensity, we defined the relative treatment intensity (RTI) as the number of courses administered multiplied by the relative dose intensity (RDI). RESULTS The estimated four-year overall survival rates (OS) of the patients aged 75-80 and ≥ 80 were 55.1% and 60.6%, respectively. There was no significant difference in four-year OS between these age groups. In our cohort, there was no significant difference in the estimated four-year OS between the patients who received reduced-dose R-THP-COP at an RDI of ≥61% and those that received it at an RDI of <61% (P = 0.35). On the other hand, the patients who received reduced-dose R-THP-COP at an RTI of ≥2.7 exhibited a significantly higher estimated four-year OS than those treated at an RTI of <2.7 (68.5% vs. 28.7%; P < 0.001). Multivariate analysis revealed that the RTI was a significant independent predictor of OS. The cumulative incidence of treatment-related mortality (TRM) at one year was 4.2% and 3.4% in the 75-80 and ≥ 80 age groups, respectively. The cumulative incidence of TRM was significantly worse among the patients with Charlson Comorbidity Index (CCI) scores of ≥2 than among those with CCI scores of 0 or 1. DISCUSSION Our study suggests that the reduced-dose R-THP-COP regimen is a suitable treatment option for older patients with DLBCL, especially those with CCI scores of <2. Our study also showed that the RTI may be a valuable tool for assessing treatment intensity in retrospective studies involving older patients.
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Affiliation(s)
- Takayuki Hiroi
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan; Department of Internal Medicine, Kainan Municipal Medical Center, Wakayama, Japan
| | - Hiroki Hosoi
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan; Department of Internal Medicine, Kainan Municipal Medical Center, Wakayama, Japan.
| | - Kodai Kuriyama
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan; Department of Internal Medicine, Kainan Municipal Medical Center, Wakayama, Japan; Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Shogo Murata
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Masaya Morimoto
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan; Department of Hematology, Kinan Hospital, Wakayama, Japan
| | - Toshiki Mushino
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan; Department of Hematology, Kinan Hospital, Wakayama, Japan
| | - Akinori Nishikawa
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Shinobu Tamura
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan; Department of Hematology, Kinan Hospital, Wakayama, Japan
| | - Takashi Sonoki
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
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Nakamura H, Hara T, Mabuchi R, Matsumoto T, Nakamura N, Ninomiya S, Kitagawa J, Kanemura N, Kito Y, Takami T, Miyazaki T, Takeuchi T, Shimizu M, Tsurumi H. Clinical significance of oxidative stress for untreated patients with diffuse large B-cell lymphoma. Mol Clin Oncol 2021; 16:4. [PMID: 34824844 DOI: 10.3892/mco.2021.2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/14/2021] [Indexed: 11/05/2022] Open
Abstract
Oxidative stress serves an important role in carcinogenesis. The present study investigated the clinical significance of oxidative stress as a prognostic factor for diffuse large B-cell lymphoma (DLBCL). The participants comprised 55 consecutive patients with DLBCL. A commercially available derivatives of reactive oxygen metabolites (d-ROMs) test kit was used to assess oxidant levels. Similarly, a commercially available biological antioxidant potential (BAP) test was used to assess antioxidant levels. The antioxidative/oxidative stress ratio was calculated as d-ROMs/BAP. The median serum concentration of d-ROMs was 425 µM. The levels of d-ROMs were significantly higher in patients with DLBCL than in healthy volunteers (P<0.01). The complete remission (CR) rates in patients with d-ROMs <425 and ≥425 µM were 81.5 and 85.7%, respectively [not significant (NS)]. The 3-year overall survival (OS) rates for patients with d-ROMs <425 and ≥425 µM were 67.2 and 72.0%, respectively (NS). The median BAP was 2,002 µM. The CR rates of patients with BAP <2,002 and ≥2,002 µM were 77.8 and 88.9%, respectively (NS). The 3-year OS rates of patients with BAP <2,002 and ≥2,002 µM were 60.9 and 75.9%, respectively (NS). No significant difference in the d-ROMs/BAP ratio was observed between groups. Multivariate analysis revealed that d-ROMs were an independent prognostic factor for progression-free survival.
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Affiliation(s)
- Hiroshi Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Takeshi Hara
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.,Department of Hematology, Matsunami General Hospital, Kasamatsu-cho, Hashima-gun, Gifu 501-6062, Japan
| | - Ryoko Mabuchi
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Takuro Matsumoto
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Nobuhiko Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Soranobu Ninomiya
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Junichi Kitagawa
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Nobuhiro Kanemura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Tsuyoshi Takami
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | | | - Tamotsu Takeuchi
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Masahito Shimizu
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
| | - Hisashi Tsurumi
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.,Department of Hematology, Matsunami General Hospital, Kasamatsu-cho, Hashima-gun, Gifu 501-6062, Japan
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Tavares A, Moreira I. Diffuse large B-cell lymphoma in very elderly patients: Towards best tailored treatment - A systematic review. Crit Rev Oncol Hematol 2021; 160:103294. [PMID: 33675907 DOI: 10.1016/j.critrevonc.2021.103294] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/02/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Diffuse large B cell Lymphoma (DLBCL) is a potentially curative lymphoma with increasing incidence with ageing. Treatment of elderly DLBCL patients represents a particular challenge due to their comorbidities and performance status. METHODS A search for original articles focused on the treatment of elderly DLBCL patients was performed in PubMed database and 633 were found and reviewed. Thirty-eight studies meeting our inclusion criteria were published since 2007. RESULTS Thirteen studies were retrospective and 25 phase II/III clinical trials. Most of them investigated the efficacy of dose-adjusted R-CHOP regimen. Alternative therapeutic drugs together with geriatric assessment were also evaluated. For fit patients aged 80 and over, the strongest evidence favours R-miniCHOP regimen. CONCLUSION A dose-adjusted R-CHOP may be the recommended treatment in elderly DLBCL patients. New tools such as the Comprehensive Geriatric Assessment provide useful guidance for treatment choice, based on comorbidities and frailty index of this group.
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Affiliation(s)
- Alda Tavares
- Department of Medical Oncology, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal.
| | - Ilídia Moreira
- Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal
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Hara T, Yoshikawa T, Goto H, Sawada M, Yamada T, Fukuno K, Kasahara S, Shibata Y, Matsumoto T, Mabuchi R, Nakamura N, Nakamura H, Ninomiya S, Kitagawa J, Kanemura N, Nannya Y, Katsumura N, Takahashi T, Kito Y, Takami T, Miyazaki T, Takeuchi T, Shimizu M, Tsurumi H. R-THP-COP versus R-CHOP in patients younger than 70 years with untreated diffuse large B cell lymphoma: A randomized, open-label, noninferiority phase 3 trial. Hematol Oncol 2018; 36:638-644. [DOI: 10.1002/hon.2524] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Takeshi Hara
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
- Department of Hematology; Matsunami General Hospital; Kasamatsu Japan
| | - Takeshi Yoshikawa
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hideko Goto
- Division of Hematology; Gifu Municipal Hospital; Gifu Japan
| | - Michio Sawada
- Department of Hematology; Gifu Red-Cross Hospital; Gifu Japan
| | - Toshiki Yamada
- Department of Hematology; Gifu Prefectural General Medical Center; Gifu Japan
| | - Kenji Fukuno
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Senji Kasahara
- Division of Hematology; Gifu Municipal Hospital; Gifu Japan
| | - Yuhei Shibata
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Takuro Matsumoto
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Ryoko Mabuchi
- Department of Internal Medicine; Kisogawa Municipal Hospital; Kisogawa Japan
| | - Nobuhiko Nakamura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hiroshi Nakamura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Soranobu Ninomiya
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Junichi Kitagawa
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Nobuhiro Kanemura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Yasuhito Nannya
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Naoki Katsumura
- Department of Internal Medicine; Chuno Kosei Hospital; Seki Japan
| | - Takeshi Takahashi
- Department of Hematology; Matsunami General Hospital; Kasamatsu Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Tsuyoshi Takami
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | | | - Tamotsu Takeuchi
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Masahito Shimizu
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hisashi Tsurumi
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
- Department of Hematology; Matsunami General Hospital; Kasamatsu Japan
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Hasebe S, Tanaka K, Miyake Y, Asai H, Takeuchi K, Fujii T, Kawazoe H, Tanimoto K, Yamanouchi J, Azuma T, Yasukawa M, Yakushijin Y. Analysis of Clinical Factors and Mortality in Diffuse Large B-cell Lymphoma Patients Over or Under 80 Years of Age. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2017.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Beygi S, Sadashiv S, Reilly JB, Khan C, Lister J. Frontline treatment of diffuse large B-cell lymphoma in elderly: a systematic review of clinical trials in post-rituximab era. Leuk Lymphoma 2018; 59:2847-2861. [PMID: 29616868 DOI: 10.1080/10428194.2018.1443332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Treatment of diffuse large B cell lymphoma (DLBCL) remains challenging in elderly population and systematic reviews are lacking in this area. Medline and Cochrane Register of Controlled Trials in addition to conference proceedings were searched for therapeutic clinical trials on frontline treatment of DLBCL in adults ≥60 in post-rituximab era. Forty-one out of 713 reviewed papers met our inclusion criteria. Six cycles of rituximab, cyclophosphamide, vincristine, prednisone (R-CHOP) administered every 21 d remain the standard treatment for fit elderly, with no role for maintenance rituximab. For individuals ≥80, the strongest evidence favors rituximab/ofatumumab-miniCHOP. Numerous alternative approaches including the use of liposomal anthracyclines, dose and regimen adjustment to frailty/comorbidity score, brief duration regimens, and consolidative radioimmunotherapy have produced promising outcomes and could be considered for R-CHOP inappropriate elderly. Phase III randomized trials studying the efficacy of liposomal vincristine, extended-exposure rituximab, and lenalidomide plus R-CHOP are ongoing.
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Affiliation(s)
- Sara Beygi
- a Allegheny Health Network, Department of Internal Medicine , Pittsburgh , PA , USA
| | - Santhosh Sadashiv
- b Allegheny Health Network, Division of Hematology and Cellular Therapy , West Penn Hospital , Pittsburgh , PA , USA
| | - James B Reilly
- c Allegheny Health Network, Department of Internal Medicine , Office of Graduate Medical Education , Pittsburgh , PA , USA
| | - Cyrus Khan
- b Allegheny Health Network, Division of Hematology and Cellular Therapy , West Penn Hospital , Pittsburgh , PA , USA
| | - John Lister
- b Allegheny Health Network, Division of Hematology and Cellular Therapy , West Penn Hospital , Pittsburgh , PA , USA
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Araie H, Sakamaki I, Matsuda Y, Tai K, Ikegaya S, Itoh K, Kishi S, Oiwa K, Okura M, Tasaki T, Hosono N, Ueda T, Yamauchi T. 3A Comparison between R-THP-COP and R-CHOP Regimens for the Treatment of Diffuse Large B-cell Lymphoma in Old Patients: A Single-institution Analysis. Intern Med 2017; 56:2407-2413. [PMID: 28824057 PMCID: PMC5643166 DOI: 10.2169/internalmedicine.8291-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective We retrospectively compared the clinical efficacy and toxicity of rituximab (R)-THP-COP (pirarubicin, cyclophosphamide, vincristine, and prednisolone) with that of R-CHOP (rituximab, adriamicin, cyclophosphamide, vincristine, and prednisolone) in previously untreated old patients with diffuse large B-cell lymphoma (DLBCL). Patients and Methods Patients admitted to our institution between 2004 and 2013 were examined. The patients received either R (375 mg/m2, day 1)-THP-COP (pirarubicin 50 mg/m2 day 1, cyclophosphamide 750 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, and prednisolone 100 mg day 1-5) or R-CHOP (adriamicin 50 mg/m2 day 1, cyclophosphamide 750 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, and prednisolone 100 mg day 1-5). The doses of chemotherapeutic agents were adjusted depending on the patient's age and associated complications. The treatment was performed for 6 to 8 cycles. Results Among 74 patients with DLBCL (median 76, range 65-90 years; male 39, female 35), 29 received R-THP-COP, while 45 received R-CHOP. The overall response rates were 94.6% (complete response 86.4%, partial response 8.1%). The 2-year overall and progression-free survival rates were 77.6% and 68.5% for the R-THP-COP regimen and 79.2% and 78.9% for R-CHOP, respectively. No significant differences were found between these two regimens regarding the clinical efficacies. The most frequent adverse event was neutropenia (72.4% for the R-THP-COP regimen, 88.9% for the R-CHOP regimen). The cardiac function as evaluated by ejection fraction values was not impaired in either regimen. Conclusion R-THP-COP was effective and safe as an alternative to R-CHOP.
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Affiliation(s)
- Hiroaki Araie
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Ippei Sakamaki
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Yasufumi Matsuda
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Katsunori Tai
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Satoshi Ikegaya
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Kazuhiro Itoh
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Shinji Kishi
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Miyuki Okura
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Toshiki Tasaki
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Naoko Hosono
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, University of Fukui, Japan
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Hayashi H, Suzuki A, Ohata K, Ishihara M, Kubota Y, Kobayashi R, Shibata Y, Nakamura H, Nakamura N, Kitagawa J, Tsurumi H, Shimizu M, Itoh Y. Control of Constipation in Patients Receiving CHOP or CHOP-Like Chemotherapy Regimens for Non-Hodgkin's Lymphoma. Biol Pharm Bull 2017; 40:698-702. [PMID: 28458356 DOI: 10.1248/bpb.b16-01001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Management of constipation in patients receiving cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) or CHOP-like chemotherapy regimens is important for prevention of paralytic ileus. We reported earlier that the laxative action of magnesium oxide is reversed by the concomitant use of antacids in cancer patients receiving opioid analgesics. Here, we assessed the prevalence of prophylactic laxative medication for the control of constipation in patients receiving CHOP or CHOP-like regimens for non-Hodgkin's lymphoma. Data obtained from 211 eligible patients were retrospectively analyzed. Almost all patients (99%) received anti-ulcer agents such as proton pump inhibitors and H2 receptor antagonists for the prophylaxis of gastric disorders associated with prednisolone. Prophylactic laxatives were prescribed in 86 patients (40.8%), in which magnesium oxide was used most predominantly (88.4%). However, magnesium oxide at doses of ≦2000 mg/d was not effective for prevention of constipation, although the compound totally inhibited the incidence of constipation at doses higher than 2000 mg/d. Therefore, it is important to avoid negative drug interaction between magnesium oxide and antacids in patients receiving CHOP chemotherapy.
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Affiliation(s)
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital
| | - Koichi Ohata
- Department of Pharmacy, Gifu University Hospital
| | | | - Yushi Kubota
- Department of Pharmacy, Gifu University Hospital
| | | | - Yuhei Shibata
- First Department of Internal Medicine, Gifu University Graduate School of Medicine
| | - Hiroshi Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine
| | - Nobuhiko Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine
| | - Junichi Kitagawa
- First Department of Internal Medicine, Gifu University Graduate School of Medicine
| | - Hisashi Tsurumi
- First Department of Internal Medicine, Gifu University Graduate School of Medicine
| | - Masahito Shimizu
- First Department of Internal Medicine, Gifu University Graduate School of Medicine
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Miura K, Konishi J, Miyake T, Makita M, Hojo A, Masaki Y, Uno M, Ozaki J, Yoshida C, Niiya D, Kitazume K, Maeda Y, Takizawa J, Sakai R, Yano T, Yamamoto K, Sunami K, Hiramatsu Y, Aoyama K, Tsujimura H, Murakami J, Hatta Y, Kanno M. A Host-Dependent Prognostic Model for Elderly Patients with Diffuse Large B-Cell Lymphoma. Oncologist 2017; 22:554-560. [PMID: 28408622 DOI: 10.1634/theoncologist.2016-0260] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/29/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Decision-making models for elderly patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) are in great demand. PATIENTS AND METHODS The Society of Lymphoma Treatment in Japan (SoLT-J), in collaboration with the West-Japan Hematology and Oncology Group (West-JHOG), collected and retrospectively analyzed the clinical records of ≥65-year-old patients with DLBCL treated with R-CHOP from 19 sites across Japan to build an algorithm that can stratify adherence to R-CHOP. RESULTS A total of 836 patients with a median age of 74 years (range, 65-96 years) were analyzed. In the SoLT-J cohort (n = 555), age >75 years, serum albumin level <3.7 g/dL, and Charlson Comorbidity Index score ≥3 were independent adverse risk factors and were defined as the Age, Comorbidities, and Albumin (ACA) index. Based on their ACA index score, patients were categorized into "excellent" (0 points), "good" (1 point), "moderate" (2 points), and "poor" (3 points) groups. This grouping effectively discriminated the 3-year overall survival rates, mean relative total doses (or relative dose intensity) of anthracycline and cyclophosphamide, unanticipated R-CHOP discontinuance rates, febrile neutropenia rates, and treatment-related death rates. Additionally, the ACA index showed comparable results for these clinical parameters when it was applied to the West-JHOG cohort (n = 281). CONCLUSION The ACA index has the ability to stratify the prognosis, tolerability to cytotoxic drugs, and adherence to treatment of elderly patients with DLBCL treated with R-CHOP. The Oncologist 2017;22:554-560 IMPLICATIONS FOR PRACTICE: Currently, little is known regarding how to identify elderly patients with diffuse large B-cell lymphoma who may tolerate a full dose of chemotherapy or to what extent cytotoxic drugs should be reduced in some specific conditions. The Society of Lymphoma Treatment in Japan developed a host-dependent prognostic model consisting of higher age (>75 years), hypoalbuminemia (<3.7 g/dL), and higher Charlson Comorbidity Index score (≥3) for such elderly patients. This model can stratify the prognosis, tolerability to cytotoxic drugs, and adherence to treatment of these patients and thus help clinicians in formulating personalized treatment strategies for this growing patient population.
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Affiliation(s)
- Katsuhiro Miura
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Jun Konishi
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takaaki Miyake
- Department of Oncology/Hematology, Shimane University Hospital, Shimane, Japan
| | - Masanori Makita
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Atsuko Hojo
- Division of Hematology and Oncology, Kasukabe Medical Center, Saitama, Japan
| | - Yasufumi Masaki
- Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan
| | - Masatoshi Uno
- Division of Internal Medicine, Kaneda Hospital, Okayama, Japan
| | - Jun Ozaki
- Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Chikamasa Yoshida
- Department of Hematology, National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Daigo Niiya
- Department of Hematology, Okayama Rosai Hospital, Okayama, Japan
| | - Koichi Kitazume
- Department of Hematology, Showa General Hospital, Tokyo, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Rika Sakai
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tomofumi Yano
- Department of Hematology, Okayama Rosai Hospital, Okayama, Japan
| | | | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yasushi Hiramatsu
- Department of Hematology and Oncology, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan
| | - Kazutoshi Aoyama
- Department of Hematology, Chugoku Central Hospital, Hiroshima, Japan
| | - Hideki Tsujimura
- Division of Hematology-Oncology, Chiba Cancer Center, Chiba, Japan
| | - Jun Murakami
- The Third Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yoshihiro Hatta
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Masatoshi Kanno
- Oncology Center, Nara Medical University Hospital, Nara, Japan
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Zhu R, Lu D, Chu YW, Chai A, Green M, Zhang N, Jin JY. Assessment of Correlation Between Early and Late Efficacy Endpoints to Identify Potential Surrogacy Relationships in Non-Hodgkin Lymphoma: a Literature-Based Meta-analysis of 108 Phase II and Phase III Studies. AAPS JOURNAL 2017; 19:669-681. [DOI: 10.1208/s12248-017-0056-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/07/2017] [Indexed: 12/18/2022]
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11
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Park SI, Grover NS, Olajide O, Asch AS, Wall JG, Richards KL, Sobol AL, Deal AM, Ivanova A, Foster MC, Muss HB, Shea TC. A phase II trial of bendamustine in combination with rituximab in older patients with previously untreated diffuse large B-cell lymphoma. Br J Haematol 2016; 175:281-289. [PMID: 27448091 DOI: 10.1111/bjh.14232] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/23/2016] [Indexed: 01/08/2023]
Abstract
Bendamustine in combination with rituximab (BR) has been associated with high response rates and acceptable toxicity in older patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Evaluation of BR is warranted in the front-line setting for DLBCL patients not eligible for anthracyclines or for the elderly. In this phase II study, we enrolled DLBCL patients aged ≥65 years who were poor candidates for R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) to determine the efficacy and safety of BR in previously untreated stage II-IV DLBCL. Twenty-three patients were enrolled with a median age of 80 years. 52% of patients presented with poor functional status (Eastern Cooperative Oncology Group performance score of ≥2). The overall response rate was 78% with 12 complete responses (52%). At a median follow up of 29 months, the median overall survival was 10·2 months and the median progression-free survival was 5·4 months. The most common grade 3/4 adverse events were haematological. Combination therapy with BR demonstrates high response rates as front-line therapy in frail older patients with DLBCL, but survival rates were low. BR should be used with caution in future clinical trials involving older DLBCL patients with poor functional status.
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Affiliation(s)
- Steven I Park
- Division of Hematology/Oncology, University of North Carolina, Chapel Hill, NC, USA.
| | - Natalie S Grover
- Division of Hematology/Oncology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Adam S Asch
- Division of Hematology/Oncology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | | | - Kristy L Richards
- Division of Hematology/Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Anna L Sobol
- Seby B. Jones Regional Cancer Center, Boone, NC, USA
| | - Allison M Deal
- Division of Biostatistics and Data Management, University of North Carolina, Chapel Hill, NC, USA
| | - Anastasia Ivanova
- Division of Biostatistics and Data Management, University of North Carolina, Chapel Hill, NC, USA
| | - Matthew C Foster
- Division of Hematology/Oncology, University of North Carolina, Chapel Hill, NC, USA
| | - Hyman B Muss
- Division of Hematology/Oncology, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Shea
- Division of Hematology/Oncology, University of North Carolina, Chapel Hill, NC, USA
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12
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Shibata Y, Hara T, Matsumoto T, Nakamura N, Nakamura H, Ninomiya S, Kitagawa J, Goto N, Nannya Y, Ito H, Kito Y, Miyazaki T, Takeuchi T, Saito K, Seishima M, Takami T, Moriwaki H, Shimizu M, Tsurumi H. Serum concentrations ofl-kynurenine predict clinical outcomes of patients with peripheral T-cell lymphoma, not otherwise specified. Hematol Oncol 2016; 35:637-644. [DOI: 10.1002/hon.2318] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 04/26/2016] [Accepted: 05/11/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Yuhei Shibata
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Takeshi Hara
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Takuro Matsumoto
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Nobuhiko Nakamura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hiroshi Nakamura
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Soranobu Ninomiya
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Junichi Kitagawa
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Naoe Goto
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Yasuhito Nannya
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hiroyasu Ito
- Department of Informative Clinical Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | | | - Tamotsu Takeuchi
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Kuniaki Saito
- Human Health Sciences, Graduate School of Medicine and Faculty of Medicine; Kyoto University; Kyoto Japan
| | - Mitsuru Seishima
- Department of Informative Clinical Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Tsuyoshi Takami
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hisataka Moriwaki
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Masahito Shimizu
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hisashi Tsurumi
- First Department of Internal Medicine; Gifu University Graduate School of Medicine; Gifu Japan
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13
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Wu Y, Ni Z, Yan X, Dai X, Hu C, Zheng Y, He F, Lian J. Targeting the MIR34C-5p-ATG4B-autophagy axis enhances the sensitivity of cervical cancer cells to pirarubicin. Autophagy 2016; 12:1105-17. [PMID: 27097054 DOI: 10.1080/15548627.2016.1173798] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Pirarubicin (THP) is a newer generation anthracycline anticancer drug. In the clinic, THP and THP-based combination therapies have been demonstrated to be effective against various tumors without severe side effects. However, previous clinical studies have shown that most patients with cervical cancer are not sensitive to THP treatment, and the associated mechanisms are not clear. Consistent with the clinical study, we confirmed that cervical cancer cells were resistant to THP in vitro and in vivo. Our data demonstrated that THP induced a protective macroautophagy/autophagy response in cervical cancer cells, and suppression of this autophagy dramatically enhanced the cytotoxicity of THP. By scanning the mRNA level change of autophagy-related genes, we found that the upregulation of ATG4B (autophagy-related 4B cysteine peptidase) plays an important role in THP-induced autophagy. Moreover, THP increased the mRNA level of ATG4B in cervical cancer cells by promoting mRNA stability without influencing its transcription. Furthermore, THP triggered a downregulation of MIR34C-5p, which was associated with the upregulation of ATG4B and autophagy induction. Overexpression of MIR34C-5p significantly decreased the level of ATG4B and attenuated autophagy, accompanied by enhanced cell death and apoptosis in THP-treated cervical cancer cells. These results for the first time reveal the presence of a MIR34C-5p-ATG4B-autophagy signaling axis in THP-treated cervical cancer cells in vitro and in vivo, and the axis, at least partially, accounts for the THP nonsensitivity in cervical cancer patients. This study may provide a new insight for improving the chemotherapeutic effect of THP, which may be beneficial to the further clinical application of THP in cervical cancer treatment.
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Affiliation(s)
- Yaran Wu
- a Department of Biochemistry and Molecular Biology , College of Basic Medical Sciences, Third Military Medical University , Chongqing , China
| | - Zhenhong Ni
- a Department of Biochemistry and Molecular Biology , College of Basic Medical Sciences, Third Military Medical University , Chongqing , China
| | - Xiaojing Yan
- a Department of Biochemistry and Molecular Biology , College of Basic Medical Sciences, Third Military Medical University , Chongqing , China
| | - Xufang Dai
- b Department of Educational College , Chongqing Normal University , Chongqing , China
| | - Changjiang Hu
- c Department of Gastroenterology , Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Yingru Zheng
- d Department of Obstetrics and Gynecology , Daping Hospital, Research Institute of Surgery, Third Military Medical University , Chongqing , China
| | - Fengtian He
- a Department of Biochemistry and Molecular Biology , College of Basic Medical Sciences, Third Military Medical University , Chongqing , China
| | - Jiqin Lian
- a Department of Biochemistry and Molecular Biology , College of Basic Medical Sciences, Third Military Medical University , Chongqing , China
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14
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Shibata Y, Hara T, Kasahara S, Yamada T, Sawada M, Mabuchi R, Matsumoto T, Nakamura N, Nakamura H, Ninomiya S, Kitagawa J, Kanemura N, Kito Y, Goto N, Miyazaki T, Takami T, Takeuchi T, Shimizu M, Tsurumi H. CHOP or THP-COP regimens in the treatment of newly diagnosed peripheral T-cell lymphoma, not otherwise specified: a comparison of doxorubicin and pirarubicin. Hematol Oncol 2015; 35:163-171. [DOI: 10.1002/hon.2262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/11/2015] [Accepted: 08/25/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Yuhei Shibata
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Takeshi Hara
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Senji Kasahara
- Department of Hematology; Gifu Municipal Hospital; Gifu Japan
| | - Toshiki Yamada
- Department of Hematology; Gifu Prefectural General Medical Center; Gifu Japan
| | - Michio Sawada
- Department of Hematology; Japanese Red Cross Gifu Hospital; Gifu Japan
| | - Ryoko Mabuchi
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
- Department of Internal Medicine; Kisogawa Municipal Hospital; Gifu Japan
| | - Takuro Matsumoto
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Nobuhiko Nakamura
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hiroshi Nakamura
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Soranobu Ninomiya
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Junichi Kitagawa
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Nobuhiro Kanemura
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Naoe Goto
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | | | - Tsuyoshi Takami
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Tamotsu Takeuchi
- Department of Pathology and Translational Research; Gifu University Graduate School of Medicine; Gifu Japan
| | - Masahito Shimizu
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Hisashi Tsurumi
- Department of Hematology; Gifu University Graduate School of Medicine; Gifu Japan
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15
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Nakamura N, Hara T, Shibata Y, Matsumoto T, Nakamura H, Ninomiya S, Kito Y, Kitagawa J, Kanemura N, Goto N, Shiraki M, Miyazaki T, Takeuchi T, Shimizu M, Tsurumi H. Sarcopenia is an independent prognostic factor in male patients with diffuse large B-cell lymphoma. Ann Hematol 2015; 94:2043-53. [PMID: 26385388 DOI: 10.1007/s00277-015-2499-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/08/2015] [Indexed: 12/17/2022]
Abstract
Sarcopenia reportedly predicts poor outcomes in elderly patients with diffuse large B-cell lymphoma (DLBCL). However, because previous studies only involved elderly patients, it is difficult to generalize these results to all patients with DLBCL. We retrospectively analyzed 207 patients with DLBCL who received the R-CHOP or R-THP-COP regimen between June 2004 and May 2014. Sarcopenia was measured by the analysis of CT images at the L3 level before treatment. The surface of muscular tissues was selected according to the CT Hounsfield unit. This value was normalized for stature in order to calculate the L3 skeletal muscle index (L3 SMI, cm(2)/m(2)). Median age at diagnosis in the 121 males and 86 females was 67 years (range, 19-86 years). The sex-specific cutoffs for the L3 SMI were determined by receiver operator curve (ROC) analysis. Sarcopenic patients were older than non-sarcopenic patients, with a median age of 70 and 65 years, respectively (p < 0.001). Other International Prognostic Index factors were not significantly different when comparing sarcopenic and non-sarcopenic patients. With a median follow-up of 50.4 months, the 3-year overall survival (OS) was 70 % in the sarcopenic group and 85 % in the non-sarcopenic group (p = 0.0260). In a subgroup analysis by gender, there was a significant difference in the OS when comparing sarcopenic and non-sarcopenic patients in males but not in females (p = 0.0003, p = 0.4440, respectively). Sarcopenia is an independent prognostic factor in male patients with DLBCL.
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Affiliation(s)
- Nobuhiko Nakamura
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takeshi Hara
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yuhei Shibata
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takuro Matsumoto
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiroshi Nakamura
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Soranobu Ninomiya
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yusuke Kito
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junichi Kitagawa
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Nobuhiro Kanemura
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Naoe Goto
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Makoto Shiraki
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | | | - Tamotsu Takeuchi
- Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masahito Shimizu
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hisashi Tsurumi
- Department of Hematology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
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16
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Higuchi M, Sasaki S, Kawadoko SI, Uchiyama H, Yasui T, Kamihira T, Aoki KI, Sasaguri T, Nakano R, Uchiyama A, Muta T, Ohshima K. Epstein–Barr virus-positive diffuse large B-cell lymphoma following acute myeloid leukemia: a common clonal origin indicated by chromosomal translocation t(3;4)(p25;q21). Int J Hematol 2015; 102:482-7. [DOI: 10.1007/s12185-015-1802-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/09/2015] [Accepted: 04/13/2015] [Indexed: 11/25/2022]
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17
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Okada N, Hanafusa T, Sakurada T, Teraoka K, Kujime T, Abe M, Shinohara Y, Kawazoe K, Minakuchi K. Risk Factors for Early-Onset Peripheral Neuropathy Caused by Vincristine in Patients With a First Administration of R-CHOP or R-CHOP-Like Chemotherapy. J Clin Med Res 2014; 6:252-60. [PMID: 24883150 PMCID: PMC4039096 DOI: 10.14740/jocmr1856w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Peripheral neuropathy is a well-known side effect of vincristine (VCR), a microtubule inhibitor used for R-CHOP or R-CHOP-like (namely R-CVP and R-THP-COP) regimens. Previous studies have shown that both the total dose of VCR and the number of treatment cycles are related to the incidence of VCR-induced peripheral neuropathy (VIPN). However, VIPN will also occur during the first treatment cycle regardless of the total dose of VCR or number of treatment cycles (early-onset VIPN). There is little information about early-onset VIPN, and it is difficult to predict. The present study's goal was to identify risk factors for early-onset VIPN. METHODS We analyzed the case records of patients who had their first administration of an R-CHOP or R-CHOP-like regimen between April 2008 and August 2013 at Tokushima University Hospital in Tokushima, Japan. To identify the risk factors for early-onset VIPN, we performed univariate and multivariate logistic regression analyses. RESULTS Forty-one patients underwent an R-CHOP or R-CHOP-like regimen for the first time at Tokushima University Hospital between April 2008 and August 2013, and 14 patients had grade 1 or higher early-onset VIPN. A univariate analysis revealed that age, the dose of VCR and the concomitant use of aprepitant appeared to be the risk factors of early-onset VIPN. In our calculation using receiver-operator characteristics curves, the cut-off value for patient age was 65 years and that of the dose of VCR was 1.9 mg. A multivariate analysis revealed that VCR dose ≥ 1.9 mg and the concomitant use of the antiemetic aprepitant were independent risk factors for early-onset VIPN. CONCLUSIONS Our present study showed that the patients who had VCR dose ≥ 1.9 mg and the concomitant use of aprepitant had the risk for early-onset VIPN. This suggests that it is important to use aprepitant in light of the risk of early-onset VIPN and the benefit of aprepitant's antiemetic effect in R-CHOP and R-CHOP-like regimens.
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Affiliation(s)
- Naoto Okada
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Takeshi Hanafusa
- Faculty of Pharmaceutical Sciences, University of Tokushima, Shomachi-1, Tokushima 770-8505, Japan
| | - Takumi Sakurada
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Kazuhiko Teraoka
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Toshihide Kujime
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Masahiro Abe
- Department of Medicine and Bioregulatory Sciences, Graduate School of Medical Sciences, University of Tokushima, 3-8-15 Kuramoto, Tokushima 770-8503, Japan
| | - Yasuo Shinohara
- Institute for Genome Research, University of Tokushima, 3 Kuramoto, Tokushima 770-8503, Japan
| | - Kazuyoshi Kawazoe
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan ; Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
| | - Kazuo Minakuchi
- Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan ; Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
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18
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Zinzani PL, Federico M, Oliva S, Pinto A, Rigacci L, Specchia G, Tucci A, Vitolo U. The more patients you treat, the more you cure: managing cardiotoxicity in the treatment of aggressive non-Hodgkin lymphoma. Leuk Lymphoma 2014; 56:12-25. [DOI: 10.3109/10428194.2014.894187] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Okayama S, Dote Y, Takeda Y, Uemura S, Fujimoto S, Saito Y. Primary Cardiac Lymphoma: Echocardiography and F-18-Fluorodeoxyglucose Positron Emission Tomography in Selection of a Biopsy Site. Echocardiography 2012; 30:E13-5. [DOI: 10.1111/echo.12006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Satoshi Okayama
- First Department of Internal Medicine; Nara Medical University; Nara; Japan
| | - Yoko Dote
- First Department of Internal Medicine; Nara Medical University; Nara; Japan
| | - Yukiji Takeda
- First Department of Internal Medicine; Nara Medical University; Nara; Japan
| | - Shiro Uemura
- First Department of Internal Medicine; Nara Medical University; Nara; Japan
| | - Shinichi Fujimoto
- Center for Education Development; Nara Medical University; Nara; Japan
| | - Yoshihiko Saito
- First Department of Internal Medicine; Nara Medical University; Nara; Japan
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20
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Zheng SE, Xiong S, Lin F, Qiao GL, Feng T, Shen Z, Min DL, Zhang CL, Yao Y. Pirarubicin inhibits multidrug-resistant osteosarcoma cell proliferation through induction of G2/M phase cell cycle arrest. Acta Pharmacol Sin 2012; 33:832-8. [PMID: 22580740 DOI: 10.1038/aps.2012.20] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIM Pirarubicin (THP) is recently found to be effective in treating patients with advanced, relapsed or recurrent high-grade osteosarcoma. In this study, the effects of THP on the multidrug-resistant (MDR) osteosarcoma cells were assessed, and the underlying mechanisms for the disruption of cell cycle kinetics by THP were explored. METHODS Human osteosarcoma cell line MG63 and human MDR osteosarcoma cell line MG63/DOX were tested. The cytotoxicity of drugs was examined using a cell proliferation assay with the Cell Counting Kit-8 (CCK-8). The distribution of cells across the cell cycle was determined with flow cytometry. The expression of cell cycle-regulated genes cyclin B1 and Cdc2 (CDK1), and the phosphorylated Cdc2 and Cdc25C was examined using Western blot analyses. RESULTS MG63/DOX cells were highly resistant to doxorubicin (ADM) and gemcitabine (GEM), but were sensitive or lowly resistant to THP, methotrexate (MTX) and cisplatin (DDP). Treatment of MG63/DOX cells with THP (200-1000 ng/mL) inhibited the cell proliferation in time- and concentration-dependent manners. THP (50-500 ng/mL) induced MG63/DOX cell cycle arrest at the G(2)/M phase in time- and concentration-dependent manners. Furthermore, the treatment of MG63/DOX cells with THP (200-1000 ng/mL) downregulated cyclin B1 expression, and decreased the phosphorylated Cdc2 at Thr(161). Conversely, the treatment increased the phosphorylated Cdc2 at Thr(14)/Tyr(15) and Cdc25C at Ser(216), which led to a decrease in Cdc2-cyclin B1 activity. CONCLUSION The cytotoxicity of THP to MG63/DOX cells may be in part due to its ability to arrest cell cycle progression at the G(2)/M phase, which supports the use of THP for managing patients with MDR osteosarcoma.
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21
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Toshikuni N, Maeda T, Ueda Y. Do hepatitis C Virus genotypes influence liver dysfunction following rituximab-containing regimens in patients with diffuse large B cell lymphoma? Acta Haematol 2012; 127:178-81. [PMID: 22343527 DOI: 10.1159/000335622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 12/05/2011] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Alanine Transaminase/metabolism
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antigens, CD20/immunology
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Drug Therapy, Combination
- Female
- Genotype
- Hepacivirus/genetics
- Hepatitis C/complications
- Hepatitis C/pathology
- Humans
- Liver/drug effects
- Liver/metabolism
- Liver/physiopathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Male
- Middle Aged
- RNA, Viral/analysis
- Risk Factors
- Rituximab
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Affiliation(s)
- Nobuyuki Toshikuni
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Japan.
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22
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Ninomiya S, Hara T, Tsurumi H, Goto N, Saito K, Seishima M, Takami T, Moriwaki H. Indoleamine 2,3-dioxygenase expression and serum kynurenine concentrations in patients with diffuse large B-cell lymphoma. Leuk Lymphoma 2012; 53:1143-5. [PMID: 22112045 DOI: 10.3109/10428194.2011.643472] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Soranobu Ninomiya
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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23
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Tsurumi H, Hara T, Goto N, Kitagawa JI, Kanemura N, Yoshikawa T, Kasahara S, Goto H, Fukuno K, Yamada T, Sawada M, Shimizu M, Takahashi T, Takami T, Moriwaki H. A phase II study of rituximab combined with pirarubicin–cyclophosphamide, vincristine and prednisolone regimen as first-line therapy for patients with indolent B-cell lymphoma. Leuk Lymphoma 2011; 53:247-53. [DOI: 10.3109/10428194.2011.606383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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