Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Hatzl, S; Posch, F; Rezai, A; Gornicec, M; Beham-Schmid, C; Magnes, T; Wangner, S; Deutsch, A; Greinix, H; Uhl, B; Prochazka, KT; Egle, A; Greil, R; Melchardt, T; Linkesch, W; Schulz, E; Neumeister, P.
Vinorelbine as substitute for vincristine in patients with diffuse large B cell lymphoma and vincristine-induced neuropathy.
Support Care Cancer. 2021; 29(9):5197-5207
Doi: 10.1007/s00520-021-06059-2
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- Führende Autor*innen der Med Uni Graz
- Hatzl Stefan
- Neumeister Peter
- Co-Autor*innen der Med Uni Graz
- Beham-Schmid Christine
- Deutsch Alexander
- Greinix Hildegard
- Linkesch Werner
- Posch Florian
- Prochazka Katharina
- Schulz Eduard
- Uhl Barbara
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- Abstract:
- BACKGROUND: A combination of rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the standard first-line therapy for diffuse large B cell lymphoma (DLBCL), the most common aggressive lymphoma in adults. One of the major adverse effects of this regimen is vincristine-induced polyneuropathy which leads to discontinuation of vincristine in up to 30% of DLBCL-patients. Dose reduction of vincristine might worsen treatment outcomes of DLBCL but identification of treatment alternatives for patients exhibiting peripheral neuropathy during R-CHOP is an unmet need in hematology. METHODS: In this retrospective cohort study, comprising 987 patients with de novo DLBCL, we delineated the role of vinorelbine as a substitute for vincristine in R-CHOP by measuring improvements in neuropathy and outcome variables. RESULTS: Five-year overall survival (OS) and progression-free survival (PFS) were 72.6% and 63.1% in patients who received regular doses of vincristine, as compared to 60.6% and 51.7% in patients who received reduced doses of vincristine (p = 0.022 and p = 0.003, respectively). Of 199 patients who switched to vinorelbine, the majority experienced an improvement of neuropathy Furthermore, vinorelbine-switched patients showed favorable oncologic outcomes. CONCLUSION: Replacement of vincristine by vinorelbine due to neuropathy is effective and safe, and results in a significant improvement in neuropathy as compared to treatment with R-CHOP.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Antineoplastic Combined Chemotherapy Protocols - adverse effects
- Cyclophosphamide - adverse effects
- Doxorubicin - adverse effects
- Female - administration & dosage
- Hematopoietic Stem Cell Transplantation - administration & dosage
- Humans - administration & dosage
- Lymphoma, Large B-Cell, Diffuse - drug therapy
- Male - administration & dosage
- Middle Aged - administration & dosage
- Peripheral Nervous System Diseases - chemically induced, epidemiology
- Prednisone - adverse effects
- Retrospective Studies - administration & dosage
- Rituximab - adverse effects
- Transplantation, Autologous - administration & dosage
- Vincristine - adverse effects
- Vinorelbine - administration & dosage
- Find related publications in this database (Keywords)
- Vino-R-CAP
- Peripheral neuropathy
- DLBCL
- R-CHOP
- Vinorelbine