Diffuse Large B-cell Lymphoma Patients Aided By More Aggressive Chemotherapy

Dr. Lowy stands near the equipment that heats the chemotherapy and pumps it into the patients abdominal cavity through tubes.

More chemotherapy, more often, may be of substantial benefit to younger people suffering from diffuse large B-cell lymphoma, a new study shows.

According to Yahoo! Health, researchers based at the University of Rouen in France have found that more-intensive-than-average chemotherapy, when combined with the monoclonal antibody drug rituximab, helps reduce the reappearance of lymphoma and increase survival rates among patients 60 years old or younger.

In conducting the study, published online Nov. 24 in The Lancet, researchers treated 379 diffuse large B-cell lymphoma patients (of ages ranging from 18 to 59), giving some of them four cycles of higher-intensity chemotherapy (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) plus rituximab at two-week intervals while offering others eight cycles of standard chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus rituximab at three-week intervals. Researchers then conducted follow-ups several years later.

Patients who underwent higher-intensity chemotherapy, researchers found, were 44 percent less likely than those who underwent traditional chemotherapy to experience a lymphatic “event” three years after treatment. Higher-intensity chemotherapy patients also had after three years a 56 percent lower risk of death and were 52 percent less likely to see their disease progress.

However, patients undergoing higher-intensity chemotherapy were also more likely to experience serious side-effects such as negative hematological and mucosal effects. Thirty-eight percent of high-dose patients suffered chemo-induced febrile neutropenia (a reduction in immune white blood cells, accompanied by illness), as opposed to 9 percent of traditional patients. As Dr. Julia Vose of the Nebraska Medical Center in Omaha wrote in an introduction to the study, as recorded by Yahoo! Health, “this dose-intense regimen should only be used in patients in whom the expected relapse rate is sufficient to justify the higher toxic effects and cost profile.” Although the ideal chemotherapeutic balance has yet to be struck, lymphoma specialists nevertheless find the study's results encouraging. "Even though the intensified regimen is associated with more toxicity, there is a significant improvement in survival in this adult population between ages 18 and 60 years of age," Dr. Arlene Redner, associate chief of oncology at Steven and Alexandra Cohen Children's Medical Center of New York, told Yahoo! Health. "This is a concept that pediatric oncologists have been using and which has been responsible for some of the excellent results that have been seen in pediatric lymphoma trials.”
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