A population-based study on different regimens of R-CHOP in patients with newly diagnosed DLBCL in The Netherlands

Abstract

Randomized controlled trials have studied different dose-intensity and dose-interval regimens of R-CHOP for patients with diffuse large B-cell lymphoma (DLBCL). This study was undertaken to confirm these results in a population-based setting, with special emphasis on the value of 6xR-CHOP21 among patients aged 18–64 years. Two thousand three hundred and thirty-eight stage II–IV DLBCL patients, ≥18 years, we confirmed the similar efficacy of six versus eight cycles of R-CHOP and of R-CHOP21 versus R-CHOP14 regimens across all age groups on overall survival (median follow-up 36.4 (1.3–167.6) months). Nevertheless, overall survival decreased with older age. Interestingly, in patients 18–64 years, the adjusted risk of mortality among recipients of 6xR-CHOP21 compared to other R-CHOP regimens seems to be similar (HR 0.62; 95%CI: 0.38–1.02; p= .059). Although this finding might suggest that 6xR-CHOP21 could be considered as first-line regimen for all stage II–IV DLBCL patients, it should be confirmed in forthcoming population-based studies with larger patient numbers and longitudinal follow-up.

Keywords:

• Diffuse large B-cell lymphoma
• R-CHOP
• population-based
• survival

Acknowledgements

The Population-based HAematological Registry for Observational Studies (PHAROS) is an initiative of the Dutch-Belgian Hemato-Oncology Group (HOVON), the Institute of Medical Technology Assessment (iMTA) at the Erasmus University Rotterdam, and the Netherlands Comprehensive Cancer Organisation (IKNL). We are grateful to all participating centers, hematologist, research nurses, and data managers for their contributions and efforts, allowing for additional data collection. Furthermore, we would like to thank the registration clerks of the Netherlands Cancer Registry (NCR) for their dedicated data collection. The nationwide population-based NCR is maintained and hosted by the Netherlands Comprehensive Cancer Organisation (IKNL).

Disclosure statement

The authors declare no competing financial interests.

Additional information

Funding

This work was financially supported by grants from The Netherlands Organization for Health Research and Development [ZonMw; #152001007].