Prognosis and complete remission rate of diffuse large B-cell lymphoma patients in standard R-CHOP with reduction of vincristine: A retrospective study

Fatemeh Riasi; Sajjad Ataei Azimi; Abolghasem Allahyari; Mohammad Moeini Nodeh; Mohammad T Shakeri; Mostafa Kamandi

doi:10.1002/hsr2.1716

Prognosis and complete remission rate of diffuse large B-cell lymphoma patients in standard R-CHOP with reduction of vincristine: A retrospective study

Health Sci Rep. 2023 Nov 28;6(12):e1716. doi: 10.1002/hsr2.1716. eCollection 2023 Dec.

Authors

Fatemeh Riasi¹, Sajjad Ataei Azimi¹, Abolghasem Allahyari², Mohammad Moeini Nodeh¹, Mohammad T Shakeri³, Mostafa Kamandi¹

Affiliations

¹ Department of Internal Medicine, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran.
² Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran.
³ Department of Biostatistics, School of Health Mashhad University of Medical Sciences Mashhad Iran.

Abstract

Background and aims: The effect of stopping or reducing the dose of vincristine in diffuse large B-cell lymphoma (DLBCL) on the outcome and prognosis of the disease is still in doubt. The present study aimed to investigate and compare the prognosis and complete remission of two R-CHOP treatment regimens with and without vincristine reduction in DLBCL patients.

Methods: This retrospective study was conducted on newly diagnosed DLBCL patients during 2018-2021. The patients were over 18 years of age, had been histologically confirmed by a pathologist, and were under treatment with R-CHOP regimen. The clinical information of the subjects as well as the number of treatment courses were extracted from their medical records and then compared.

Results: Overall, 269 patients with DLBCL were included in this study, 15.99% of whom (n = 43) had vincristine reduction. There was no significant difference between the studied factors regarding the reduction of vincristine and the complete R-CHOP regimen (p > 0.05). Besides, no difference was observed in the 1-year overall survival (OS) and progression-free survival (PFS) of the patients in the two groups treated with R-CHOP regimen with and without vincristine reduction (p > 0.05). The complete remission rates of the patients treated with R-CHOP regimen with and without vincristine (p > 0.05) were not different either. The results of the Cox multivariate regression showed that reducing the dose of vincristine from the R-CHOP treatment regimen had no relationship with the 1-year OS and PFS of the DLBCL patients (hazard ratio [HR]_OS = 1.59, 95% confidence interval [CI]: 3.67-0.690, HR_PFS = 1.67, 95% CI: 0.798-3.82).

Conclusion: The results of this study showed that the reduction of vincristine from the R-CHOP regimen in the DLBCL patients was not likely to make a difference in the 1-year OS and PFS of the patients. However, further studies are needed on the issue.

Keywords: DLBCL; R‐CHOP; prognosis; vincristine.