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Concomitant statin use does not impair the clinical outcome of patients with diffuse large B cell lymphoma treated with rituximab-CHOP

Annals of Hematology volume 89, pages 783–787 (2010)Cite this article

Abstract

Preclinical data indicated a detrimental effect of statins on the anti-lymphoma activity of rituximab. We evaluated the impact of concomitant statin medication on the response and survival of patients with diffuse large B cell lymphoma (DLBCL) receiving rituximab–cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) as first-line therapy. Medical histories of patients with DLBCL who were treated with R-CHOP as first-line therapy were assessed for concomitant statin use, response after completion of chemotherapy, event-free survival (EFS), and overall survival (OS). Furthermore, 2-[18F]fluor-2-deoxyglucose (FDG)-PET/CT results after completion of first-line therapy were compared between the groups. Overall, 145 patients with DLBCL treated with R-CHOP from January 2001 to December 2009 were analyzed. Twenty-one (15%) patients received statins throughout therapy. Five-year EFS was 67.3% in patients without statins compared with 79% in patients receiving statins during R-CHOP (HR, 0.47; 95% CI, 0.15–1.54, p = 0.2). Five-year OS was 81.4% for patients without statins compared with 93.3% for patients taking statins (HR, 0.58; 95% CI 0.07–4.55, p = 0.6). There were no statistically significant differences in the rates of complete remissions between the two groups (75% in the non-statin group versus 86% in the statin group, p = 0.45). A trend toward a lower rate of complete metabolic responses in FDG-PET/CT after chemotherapy was seen in patients without statin medication compared with the patients taking statins (84% versus 92%, p = 0.068). Concomitant statin use had no adverse impact on response to chemotherapy, EFS, and OS in patients treated with R-CHOP for DLBCL.

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Abbreviations

DLBCL:

Diffuse large B cell lymphoma

R-CHOP:

Rituximab–cyclophosphamide, doxorubicin, vincristine, prednisone

EFS:

Event-free survival

OS:

Overall survival

FDG-PET:

2-[18F]fluor-2-deoxyglucose–positron emissions tomography

CT:

Computed tomography

CD20:

Cluster of differentiation 20

IPI:

International prognostic index

HR:

Hazard ratio

CI:

Confidence interval

CR:

Complete remission

uCR:

Unconfirmed complete remission

PR:

Partial remission

SD:

Stable disease

PD:

Progressive disease

HIV:

Human immunodeficiency virus

HMG-CoAR:

3-Hydroxy-3-methylgutaryl coenzyme A reductase

CDC:

Complement-dependent cytotoxicity

ADCC:

Antibody-dependent cellular cytotoxicity

mAb:

Monoclonal antibody

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Authorship and disclosures

PS, HH, FS-L, and CR designed the study, collected, and analyzed the data and wrote the manuscript. SRH performed the statistical analysis, NGS performed the imaging analysis. RDS, UP, AM, AM, MZ, and AK participated in the patients’ care and the data analysis.

All authors were involved in the revision process and approved the final manuscript. No conflicts of interest are present.

Author information

Affiliations

  1. Department of Oncology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland

    Panagiotis Samaras, Helen Heider, Ulf Petrausch, Niklaus G. Schaefer, Alexander Meisel, Axel Mischo, Martin Zweifel, Alexander Knuth, Frank Stenner-Liewen & Christoph Renner

  2. Biostatistics Unit, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland

    Sarah R. Haile

  3. Medical Oncology, Triemli City Hospital, Zurich, Switzerland

    Raffaele Daniele Siciliano

  4. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Zurich, Switzerland

    Niklaus G. Schaefer

Authors
  1. Panagiotis Samaras
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  2. Helen Heider
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  3. Sarah R. Haile
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  4. Ulf Petrausch
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  5. Niklaus G. Schaefer
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  6. Raffaele Daniele Siciliano
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  7. Alexander Meisel
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  8. Axel Mischo
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  9. Martin Zweifel
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  10. Alexander Knuth
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  11. Frank Stenner-Liewen
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  12. Christoph Renner
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Corresponding author

Correspondence to Panagiotis Samaras.

Additional information

Panagiotis Samaras and Helen Heider contributed equally to this work.

Frank Stenner-Liewen and Christoph Renner share senior authorship.

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Samaras, P., Heider, H., Haile, S.R. et al. Concomitant statin use does not impair the clinical outcome of patients with diffuse large B cell lymphoma treated with rituximab-CHOP. Ann Hematol 89, 783–787 (2010). https://doi.org/10.1007/s00277-010-0926-0

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  • DOI: https://doi.org/10.1007/s00277-010-0926-0

Keywords

  • Statins
  • Diffuse large B cell lymphoma
  • Rituximab
  • R-CHOP
  • Survival