The Efficacy and Safety Profile of First-line R-CDOPlike Regimen in Diffuse Large B-cell Lymphoma with Cardiovascular Diseases Or High Risk Factors / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety profile of first-line R-CDOP(rituximab, cyclophosphamide, pegylated liposomal doxorubicin, vincristine, and prednisone) like regimen in diffuse large B-cell lymphoma (DLBCL) with cardiovascular diseases or risk factors. METHODS: DLBCL Patients who were diagnosed with at least one cardiovascular disease/risk factor and received first-line R-CDOPlike chemotherapy in our institute between January 2010 and November 2016 were collected. Cardiovascular diseases/risk factors were referred ascoronary heart disease, hypertension, age ≥60, hyperlipidemia, diabetes mellitus, obesity, history of smoking, and hypothyroidism/hyperthyroidism. Chemotherapy in our institute were retrospectively reviewed. RESULTS: A total of 94 DLBCL patients were recruited. All enrolled patients had history of a cardiovascular disease or presented a high-risk group of developing cardiovascular diseasescoronary heart disease 10 cases, hypertension 33 cases, hyperlipidemia 44 cases, diabetes mellitus 23 cases, obesity 15 cases, history of smoking 25 cases, hypothyroidism/hyperthyroidism 3 cases. A total of 74 patients had more than one cardiovascular disease or risk factors. A total of 34 patients were germinal center B-cell subtype(GCB) and 60 were non-germinal center B-cell subtype(non-GCB). First-line R-CDOP like chemotherapy was given at a median cycle of 4.5 (range, 2-8). Overall response rate(ORR) and complete response rate (CRR) were 92.6%(87/94) and 70.2%(66/94) for the whole group. 5-Year progression-free survival (PFS) and overall survival(OS) rates were 71.3% and 76.9% for overall. For GCB subtype and non-GCB subtype, 5-year PFS rates were 84.6% and 63.9% respectively(P<0.05), and 5-year OS rates were 80.6% and 74.6%, respectively(P=0.407). Grade III/ neutropenia and thrombocytopenia were documented in 53.2%(50/94) and 3.2% (3/94) of patients. 19 (20.2%) patients developed grade /Ⅱ cardiotoxicity. There was no grade III/ cardiac event causing chemotherapy delay or break off. No further cardiotoxicity occurred neither during follow-up. CONCLUSION: PLD-containing first-line R-CDOP like regimen is demonstrated as a highly effective and much tolerable alternative for DLBCL patients with cardiovascular diseases/risk factors.