Skip to main content

Advertisement

Log in

Impact of prednisolone dosage in the CHOP regimen for follicular lymphoma: a retrospective study

  • Original Article
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) is one of the standard regimens for indolent B-cell non-Hodgkin’s lymphoma (NHL). It is unclear whether the prednisolone (PSL) dosage affects the therapeutic effect or the adverse event profile. We retrospectively examined 48 patients with indolent B-cell NHL who were treated with R-CHOP (PSL 50 mg/m2/day for 5 days) at our institute between 2006 and 2016. We compared them with 149 patients with indolent B-cell lymphoma who were treated with R-CHOP (PSL 100 mg for 5 days) in the JCOG 0203 trial. The proportions of patients with bulky disease, extranodal involvement, and increased nodal sites were higher at our institute. Nevertheless, there was no difference in the CR rate, PFS, OS or the frequency of adverse events, except for peripheral neuropathy, between the two treatment groups. In our institute, there was no difference in the CR rate, PFS, OS or adverse event profile between patients who received PSL at 60–80 mg/day and at 81–100 mg/day. Patients who received PSL at 60–80 mg/day included many female and light-weight patients. In conclusion, the PSL dose adjusted based on body surface area appeared to be appropriate in terms of efficacy and safety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hiddemann W, Kneba M, Dreyling M, Schmitz N, Lengfelder E, Schmits R, et al. Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood. 2005;106(12):3725–32.

    Article  CAS  PubMed  Google Scholar 

  2. Crump M, Kuruvilla J, Couban S, MacDonald DA, Kukreti V, Kouroukis CT, et al. Randomized comparison of gemcitabine, dexamethasone, and cisplatin versus dexamethasone, cytarabine, and cisplatin chemotherapy before autologous stem-cell transplantation for relapsed and refractory aggressive lymphomas: NCIC-CTG LY.12. J Clin Oncol. 2014;32(31):3490–6.

    Article  CAS  PubMed  Google Scholar 

  3. Velasquez WS, McLaughlin P, Tucker S, Hagemeister FB, Swan F, Rodriguez MA, et al. ESHAP—an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994;12(6):1169–76.

    Article  CAS  PubMed  Google Scholar 

  4. Hagberg H, Gisselbrecht C. Randomised phase III study of R-ICE versus R-DHAP in relapsed patients with CD20 diffuse large B-cell lymphoma (DLBCL) followed by high-dose therapy and a second randomisation to maintenance treatment with rituximab or not: an update of the CORAL study. Ann Oncol. 2006;17(Suppl 4):31–2.

    Article  Google Scholar 

  5. Pfreundschuh M, Trumper L, Osterborg A, Pettengell R, Trneny M, Imrie K, et al. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006;7(5):379–91.

    Article  CAS  PubMed  Google Scholar 

  6. Moreno A, Colon-Otero G, Solberg LA Jr. The prednisone dosage in the CHOP chemotherapy regimen for non-Hodgkin's lymphomas (NHL): is there a standard? Oncologist. 2000;5(3):238–49.

    Article  CAS  PubMed  Google Scholar 

  7. Lee SY, Kurita N, Yokoyama Y, Seki M, Hasegawa Y, Okoshi Y, et al. Glucocorticoid-induced diabetes mellitus in patients with lymphoma treated with CHOP chemotherapy. Support Care Cancer. 2014;22(5):1385–90.

    Article  PubMed  Google Scholar 

  8. Shimizu N, Ban N, Watanabe Y, Rikitake A, Watanabe R, Tanaka S, et al. The elevation of cardio-ankle vascular index in a patient with malignant lymphoma treated with a combination therapy of rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisolone. J Clin Med Res. 2017;9(8):729–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Svendsen P, Shekhrajka N, Nielsen KL, Vestergaard P, Poulsen MO, Vistisen AK, et al. R-CHOP(-like) treatment of diffuse large B-cell lymphoma significantly reduces CT-assessed vertebral bone density: a single center study of 111 patients. Leuk Lymphoma. 2017;58(5):1105–13.

    Article  CAS  PubMed  Google Scholar 

  10. Watanabe T, Tobinai K, Shibata T, Tsukasaki K, Morishima Y, Maseki N, et al. Phase II/III study of R-CHOP-21 versus R-CHOP-14 for untreated indolent B-cell non-Hodgkin's lymphoma: JCOG 0203 trial. J Clin Oncol. 2011;29(30):3990–8.

    Article  PubMed  Google Scholar 

  11. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–86.

    Article  PubMed  Google Scholar 

  12. Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013;48(3):452–8.

    Article  CAS  PubMed  Google Scholar 

  13. Gottlieb JA, Gutterman JU, McCredie KB, Rodriguez V, Frei E 3rd. Chemotherapy of malignant lymphoma with adriamycin. Cancer Res. 1973;33(11):3024–8.

    CAS  PubMed  Google Scholar 

  14. Kagami Y, Itoh K, Tobinai K, Fukuda H, Mukai K, Chou T, et al. Phase II study of cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) therapy for newly diagnosed patients with low- and low-intermediate risk, aggressive non-Hodgkin's lymphoma: final results of the Japan Clinical Oncology Group Study, JCOG9508. Int J Hematol. 2012;96(1):74–83.

    Article  CAS  PubMed  Google Scholar 

  15. Choi EJ, Hong JY, Yoon DH, Kang J, Park CS, Huh J, et al. Treatment outcomes of dose-attenuated CHOP chemotherapy in elderly patients with peripheral T cell lymphoma. Blood Res. 2017;52(4):270–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Nakashima K, Narukawa M, Kanazu Y, Takeuchi M. Differences between Japan and the United States in dosages of drugs recently approved in Japan. J Clin Pharmacol. 2011;51(4):549–60.

    Article  PubMed  Google Scholar 

  17. O'Donnell PH, Dolan ME. Cancer pharmacoethnicity: ethnic differences in susceptibility to the effects of chemotherapy. Clin Cancer Res. 2009;15(15):4806–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Magee MH, Blum RA, Lates CD, Jusko WJ. Prednisolone pharmacokinetics and pharmacodynamics in relation to sex and race. J Clin Pharmacol. 2001;41(11):1180–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hryniuk W, Bush H. The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol. 1984;2(11):1281–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yoshinobu Kanda.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ikeda, T., Fujiwara, Si., Nakajima, H. et al. Impact of prednisolone dosage in the CHOP regimen for follicular lymphoma: a retrospective study. Int J Hematol 112, 369–376 (2020). https://doi.org/10.1007/s12185-020-02908-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-020-02908-8

Keywords

Navigation