No Evident Prognostic Benefit of Statin Use in Diffuse Large B-Cell Lymphoma Patients with Unfavorable Disease Features Treated with R-DA-EPOCH

Pharmacology. 2022;107(11-12):623-627. doi: 10.1159/000526625. Epub 2022 Oct 13.

Abstract

Recent reports indicate that patients with aggressive non-Hodgkin lymphomas might benefit if concomitantly receiving statins with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine (Oncovin) and prednisone immunochemotherapy. We retrospectively analyzed a cohort of 130 newly diagnosed diffuse large B-cell lymphomas with unfavorable clinical features treated with first-line rituximab, dose-adjusted etoposide, prednisone, vincristine [Oncovin], cyclophosphamide, hydroxydaunorubicin (R-DA-EPOCH) immunochemotherapy in period 2005-2019. A total of 17/130 (13.1%) patients received statins concomitantly with immunochemotherapy, mostly atorvastatin and in intermediate statin dose intensity. Besides tendency to be associated with older age (p = 0.070), there were no other significant associations of statins use with neither sex, disease stage, R-IPI, or other unfavorable disease features (p > 0.05 for all analyses). Also, no significant differences were present considering feasibility (number of cycles with dose escalation/reduction), toxicity (number of cycles with anemia, thrombocytopenia, neutropenia, febrile neutropenia, and septic complications) nor efficacy (response rates) of R-DA-EPOCH regimen (p > 0.05 for all analyses). Also, statin use had no significant association with neither OS (p = 0.480) nor PFS (p = 0.891). Lack of associations of statin use with relevant clinical outcomes was further corroborated by multivariate analyses.

Keywords: Atorvastatin; Lipid metabolism; Non-Hodgkin lymphoma; Survival.

Publication types

  • Clinical Trial
  • News

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Cyclophosphamide / adverse effects
  • Doxorubicin / adverse effects
  • Etoposide
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Prednisone / adverse effects
  • Prognosis
  • Retrospective Studies
  • Rituximab / adverse effects
  • Treatment Outcome
  • Vincristine / adverse effects

Substances

  • Cyclophosphamide
  • Doxorubicin
  • Etoposide
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Prednisone
  • Rituximab
  • Vincristine

Supplementary concepts

  • EPOCH protocol