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A retrospective study of the CHOP, CHOPE, and CHOPE/G regimens as the first-line treatment of peripheral T-cell lymphomas

Abstract

Purpose

The standard treatment for peripheral T-cell lymphomas (PTCLs) is undetermined. We designed a CHOPE/G regimen (cyclophosphamide, pirarubicin, vincristine, prednisolone, and etoposide alternating with a gemcitabine-based regimen) as the first-line treatment of PTCLs and compared with CHOP (cyclophosphamide, pirarubicin, vincristine, and prednisolone) and CHOPE (CHOP plus etoposide) regimen to evaluate the optimal chemotherapy regimen.

Methods

116 previously untreated PTCL patients received CHOP (N = 46), CHOPE (N = 46), or CHOPE/G (N = 24) regimen at Peking University Cancer Hospital from 2009 to 2017 and were retrospectively analyzed.

Results

The overall response rates (ORRs) of the CHOP, CHOPE, and CHOPE/G groups were 82.6%, 76.1%, and 75.0% (p = 0.673), with complete response (CR) rates of 32.6%, 56.5%, and 45.7% (p = 0.063), respectively. Within a median follow-up time of 35.5 months, the 3-year overall survival (OS) rates of the CHOP, CHOPE, and CHOPE/G groups were 37.0%, 47.0%, and 56.3% (p = 0.107), and the 3-year progression-free survival (PFS) rates were 19.9%, 29.9%, and 5.3% (p = 0.093), respectively. Compared with the CHOP regimen alone, CHOPE had a significantly higher CR rate (p = 0.021) with more favorable OS (p = 0.046). The CHOPE/G regimen did not improve the ORR, CR rate, or OS compared with either the CHOP or CHOPE, with a significantly poorer PFS compared with the CHOPE regimen (p = 0.029). Anemia and thrombocytopenia occurred most frequently in the CHOPE/G group (anemia 83.3%, p = 0.035; thrombocytopenia 50%, p = 0.015).

Conclusions

Compared with CHOP alone, CHOPE regimen improved the efficacy and survival; while the addition of gemcitabine in the front-line therapy resulted in more adverse events without benefit of survival.

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Acknowledgements

This study was funded by National Nature Science Foundation of China (Grant number 81470368 and Grant number 81670187), Beijing Natural Science Foundation (Grant number 7172047), Capital’s Funds for Health Improvement and Research (Grant number 2018-1-2151), Beijing Municipal Administration of Hospitals’ Ascent Plan (Grant number DFL20151001), and Beijing Medical and Health Foundation (Grant number 2221-16-157). We thank M.S. Lan Mi for statistical method supporting.

Funding

This study was funded by National Nature Science Foundation of China (Grant number 81470368 and grant number 81670187), Beijing Natural Science Foundation (Grant number 7172047), Capital’s Funds for Health Improvement and Research (Grant number 2018-1-2151), Beijing Municipal Administration of Hospitals’ Ascent Plan (Grant number DFL20151001), and Beijing Medical and Health Foundation (Grant number 2221-16-157).

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Correspondence to Weiping Liu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Liu, X., Yang, M., Wu, M. et al. A retrospective study of the CHOP, CHOPE, and CHOPE/G regimens as the first-line treatment of peripheral T-cell lymphomas. Cancer Chemother Pharmacol 83, 443–449 (2019). https://doi.org/10.1007/s00280-018-3744-z

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  • DOI: https://doi.org/10.1007/s00280-018-3744-z

Keywords

  • Peripheral T-cell lymphomas
  • Chemotherapy
  • CHOP
  • Etoposide
  • Gemcitabine