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Achievement of optimal average relative dose intensity and correlation with survival in diffuse large B-cell lymphoma patients treated with CHOP

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The treatment of diffuse large B-cell lymphoma with chemotherapy was retrospectively evaluated in 348 patients who had received at least three cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like, ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone)-like or CHVmP-BV (cyclophosphamide, hydroxorubicin, Vm-26, prednisone, vincristine and bleomycin) treatment in Belgium between 1995 and 2000. In our sample, the proportion who received each of the three regimens was 78.4, 16.4, and 5.2%, respectively. Of those prescribed CHOP-like regimens, 15% received <80% average relative dose intensity (ARDI). In 210 patients treated with CHOP-21 (77% of the CHOP-like group), median survival was 7.08 years in those who received >90% of the ARDI, significantly longer than in those who received ≤;90% of the ARDI (p = 0.002). Dose reductions and/or delays, mainly due to hematological toxicities, resulted in a reduction in treatment intensity. These data indicate that patient outcome is improved when the intensity of chemotherapy treatment is optimal.

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This study was supported by Amgen Belgium.

Conflict of interest statement

All authors must disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.

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Correspondence to A. Bosly.

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See Appendix for a list of participating centers and physicians.



Names of participating centers and physicians

Dr. R. De Bock (Centrumziekenhuis, campus Middelheim, Antwerpen); Dr. P. Zachée (Centrumziekenhuis campus Stuivenberg, Antwerpen); Prof. G. Verhoef (U.Z. Gasthuisberg, Leuven); Prof. Z. Berneman (U.Z. Antwerpen); Dr. Ph. Spaas (St. Norbertusziekenhuis, Duffel); Dr. D. De Bal (St. Maartenziekenhuis, Duffel); Dr. J. Meyskens (St. Elisabethziekenhuis, Turnhout); Dr. P. Specenier (AZ Jan Portaels, Vilvoorde); Dr. D. Vanstraelen (Virga Jesseziekenhuis, Hasselt); Dr. A. Van Hoof (AZ St. Jan, Brugge); Dr. M. Petrick (St. Lucasziekenhuis, Gent); Dr. K. Van Eygen (AZ Groeningen, Kortrijk); Prof. H. Demuynck (H. Hartziekenhuis, Roeselare); Dr. F. Trullemans (U.Z. V.U. Brussel); Prof. F. Offner (U.Z. Gent); Prof. A. Ferrant (U.C.L. St Luc, Bruxelles); Dr. D. Boulet (Clinique St. Joseph, Mons); Dr. M. André (C.H. Notre-Dame Reine Fabiola, Charleroi); Dr. Ph. Mineur (Clinique St. Joseph, Gilly); Prof. D. Bron (Institut J. Bordet, Bruxelles); Prof. W. Feremans (Hôpital Erasme, U.L. Bruxelles); Dr. M. Maerevoet (Clinique St. Pierre, Ottignies); Dr. S. Lampertz (Hôpital Bois de l’Abbaye, Seraing); Dr. P. Pierre (Clinique St. Joseph, Arlon); Dr. L. Montfort (Clinique St. Luc, Bouge); Prof. A. Bosly (U.C.L. Mont Godinne, Yvoir and Clinique Sainte-Elisabeth, Namur); Prof. G. Fillet (C.H.U. Sart Tilman, Liège); Dr. L. Longrée (Hôpital St Joseph, Liège); Dr. M. Reginster (C.H. Hutois, Huy), Dr. J. Collignon (C.H. Hutois, Huy).

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Bosly, A., Bron, D., Van Hoof, A. et al. Achievement of optimal average relative dose intensity and correlation with survival in diffuse large B-cell lymphoma patients treated with CHOP. Ann Hematol 87, 277–283 (2008).

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