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Titolo:
The impact of age on delivered dose intensity and hospitalizations for febrile neutropenia in patients with intermediate-grade non-Hodgkin's lymphomareceiving initial CHOP chemotherapy: A risk factor analysis
Autore:
Morrison, VA; Picozzi, V; Scott, S; Pohlman, B; Dickman, E; Lee, M; Lawless, G; Kerr, R; Caggiano, V; Delgado, D; Fridman, M; Ford, J; Carter, WB;
Indirizzi:
VA Med Ctr, Hematol Oncol Sect, Minneapolis, MN 55417 USA VA Med Ctr Minneapolis MN USA 55417 Oncol Sect, Minneapolis, MN 55417 USA Virginia Mason Med Ctr, Seattle, WA 98101 USA Virginia Mason Med Ctr Seattle WA USA 98101 ed Ctr, Seattle, WA 98101 USA Univ Iowa, Iowa City, IA USA Univ Iowa Iowa City IA USAUniv Iowa, Iowa City, IA USA Cleveland Clin Fdn, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 in Fdn, Cleveland, OH 44195 USA Meridia Canc Inst, Mayfield Heights, OH USA Meridia Canc Inst Mayfield Heights OH USA Inst, Mayfield Heights, OH USA Pk Nicollet Inst, Oncol Res Dept, Minneapolis, MN USA Pk Nicollet Inst Minneapolis MN USA Oncol Res Dept, Minneapolis, MN USA Highmark Blue Cross Blue Shield, Pittsburgh, PA USA Highmark Blue Cross Blue Shield Pittsburgh PA USA ld, Pittsburgh, PA USA SW Reg Canc Ctr, Austin, TX USA SW Reg Canc Ctr Austin TX USASW Reg Canc Ctr, Austin, TX USA Sutter Canc Ctr, Sacramento, CA USA Sutter Canc Ctr Sacramento CA USASutter Canc Ctr, Sacramento, CA USA Amgen Inc, Thousand Oaks, CA 91320 USA Amgen Inc Thousand Oaks CA USA 91320 gen Inc, Thousand Oaks, CA 91320 USA AMF Consulting Inc, Los Angeles, CA USA AMF Consulting Inc Los Angeles CAUSA onsulting Inc, Los Angeles, CA USA
Titolo Testata:
CLINICAL LYMPHOMA
fascicolo: 1, volume: 2, anno: 2001,
pagine: 47 - 56
SICI:
1526-9655(200106)2:1<47:TIOAOD>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLONY-STIMULATING FACTOR; DIFFUSE HISTIOCYTIC LYMPHOMA; CLINICAL-PRACTICE GUIDELINES; FIELD RADIATION-THERAPY; OLDER CANCER-PATIENTS; LARGE-CELL LYMPHOMA; ELDERLY PATIENTS; MALIGNANT-LYMPHOMA; COMORBIDITY INDEX; LUNG-CANCER;
Keywords:
toxicity; outcome; comorbidity; CHOP chemotherapy; neutropenia; age; G-CSF;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
60
Recensione:
Indirizzi per estratti:
Indirizzo: Morrison, VA VA Med Ctr, Hematol Oncol Sect, 111E,1 Vet Dr, Minneapolis, MN 55417 USA VA Med Ctr 111E,1 Vet Dr Minneapolis MN USA 55417 N 55417 USA
Citazione:
V.A. Morrison et al., "The impact of age on delivered dose intensity and hospitalizations for febrile neutropenia in patients with intermediate-grade non-Hodgkin's lymphomareceiving initial CHOP chemotherapy: A risk factor analysis", CLIN LYMPHO, 2(1), 2001, pp. 47-56

Abstract

The purpose of this historical case series study was to evaluate the association of age on delivered dose intensity of initial CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy and the occurrence of hospitalizations for febrile neutropenia for patients with intermediate-grade non-Hodgkin's lymphoma (NHL). Findings are reported for 12 managed community and academic practices. Medical records of 930 NHL patients not enrolled on clinical trial protocols were reviewed. We reported on 577 of the study patients (62%) who received initial CHOP chemotherapy. Median age of the patients was 65.1 years. Older patients (age greater than or equal to 65 years) had more hospitalizations for febrile neutropenia (28% vs. 16%; P < 0.05) than younger patients (age, 18-64years). In patients with advanced-stage NHL (stage III/IV), older patients received fewer cycles of CHOP (< 6 cycles, 35% vs. 22%; P < 0.05) than younger patients. Older patients were planned for lower average relative dose intensity (ARDI less than or equal to 80%; P < 0.05) and had more heart disease and comorbid conditions (P < 0.05) than younger patients. Multiple logistic regression models showed that olderpatients were more likely to receive a lower dose intensity (ARDI less than or equal to 80%; odds ratio = 2.46, 95% confidence interval [CI]: 1.62-3.72) during their first 3 cycles of therapy and to experience more hospitalizations for febrile neutropenia (odds ratio = 2.17, 95% CI: 1.43-3.30). We found the dose intensity of delivered CHOP chemotherapy for elderly patients to be less than standard CHOP therapy and the risk of hospitalizations for febrile neutropenia to be greater than in younger patients. Prospective clinical trials examining supportive care measures, such as colony-stimulating factor, for elderly NHL patients are recommended.

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Documento generato il 27/01/20 alle ore 16:52:08