Substitution of doxorubicin with etoposide in the treatment of lymphomas

master's thesis

• Title (croatian): Zamjena doksorubicina etopozidom u liječenju limfoma
• Author: Meredith Olivia Terry
• Mentor: Igor Aurer (mentor)
• Committee member: Igor Aurer (predsjednik povjerenstva)
• Committee member: Radovan Vrhovac (član povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

PURPOSE: This study set out to examine the survival and progression-free outcomes in aggressive lymphoma patients receiving (R)CEOP therapy due to contraindications for anthracycline therapy. Toxicities that developed were also evaluated and reported. ----- PATIENTS & METHODS: Hospital records were searched for patients who received (R)CEOP in >50% of chemotherapy cycles. A total of 44 patients were included from KBC Zagreb, with 33 B cell lymphoma and 11 T cell lymphoma patients. Data was analyzed to evaluate survival, risk factors, and toxicities. ----- RESULTS: Patients were followed up a median of 30.3 months. The 5 year overall survival rate was approximately 48% and event-free survival 40%. It was found that elevated LDH at diagnosis and age >70 years are poor prognostic factors, having a statistically significant correlation to poorer overall survival. All other risk and prognostic factors were not found to have a statistically significant impact on survival. The most commonly encountered toxicities were cytopenias and infections (34% and 34%). ----- CONCLUSION: (R)CEOP therapy is generally well-tolerated in patients with co-morbidities that preclude traditional anthracycline therapy. Elevated LDH and advanced age are poor prognostic factors for survival. This study found no statistically significant difference according to cell of origin in DLBCL patients and survival outcomes.

Abstract (croatian)

CILJ: Ovo istraživanje ispitalo je ukupno preživljavanje i preživljavanje bez događaja bolesnika s agresivnim limfomima koji su primali (R)CEOP terapiju zbog kontraindikacija za liječenje antraciklinima. Ispitana je i toksičnost ovog protokola. ----- BOLESNICI I METODE: Iz bolničkih povijesti bolesti su identificirani bolesnici koji su primali (R)CEOP u >50% ciklusa kemoterapije. U istraživanje je uključeno ukupno 44 bolesnika liječenih u KBC Zagrebu, 33 s B-staničnim i 11 s limfomima T stanice. Na temelju prikupljenih podataka analizirani su preživljavanje, čimbenici rizika i toksičnost. ----- REZULTATI: Medijan praćenja iznosio je 30,3 mjeseci. Petogodišnje preživljavanje iznosilo je 48%, a preživljavanje bez događaja 40%. Povišen LDH pri dijagnozi i dob >70 godina bili su statistički značajni nepovoljni prognostički faktori koji su korelirali s lošijim preživljavanjem. Za sve ostale rizike i prognostičke čimbenike nije utvrđeno da imaju statistički značajan utjecaj na preživljavanje. Najčešće toksičnosti bile su citopenije i infekcije (34% i 34%). ----- ZAKLJUČAK: Bolesnici s komorbiditetima koji onemogućavaju uobičajeno liječenje antraciklinima obično dobro podnose (R)CEOP. Povišen LDH i starija dob su prediktori lošijeg ishoda. U ovoj studiji nismo našli da postoji statistički značajna razlika u preživljavanju između bolesnika s DLBCL različitog staničnog porijekla.

• Keywords: diffuse large B-cell lymphoma; CEOP; aggressive lymphoma treatment
• Keywords (croatian): difuzni B-velikostanični limfom; CEOP; liječenje agresivnog limfoma
• Language: english
• URN:NBN: urn:nbn:hr:105:657164
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-04-25 07:27:06