Prognostic significance of actual dose intensity in diffuse large-cell lymphoma: results of a tree-structured survival analysis.

摘要: While diffuse large-cell lymphoma (DLCL) is considered to be highly curable with current therapy, treatment failures are observed even intensive combination chemotherapy regimens. In order study the prognostic significance of actual dose intensity in DLCL, we retrospectively analyzed 115 previously untreated patients treated as Stanford between 1975 and 1986 cyclophosphamide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), vincristine, prednisone (CHOP), methotrexate, bleomycin, Adriamycin, dexamethasone ([M]BACOD), or cyclosphosphamide, prednisone, bleomycin (MACOP-B). The relative (RDI), amount drug actually administered each patient during first 12 weeks was calculated standardized CHOP addition clinical factors for survival by univariate analysis. Multivariate recursive partitioning (tree-structured) analysis identified RDI greater than 75% single most important predictor survival. A model incorporating performance status, serum lactate dehydrogenase (LDH) extranodal disease, defined three overall groups respective 3-year rates 89%, 63%, 18%. remained distinct, when restricted complete responders. This also predictive optimum regimens applied a subgroup aged 50 years younger. We conclude that an factor DLCL early course may allow modification plan.