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Mytelka DS, Li L, Stafkey-Mailey D, et al. Treatment patterns and outcomes among patients with high-intermediate/high-risk diffuse large B-cell lymphoma in the USA. Hematology. 2014;20(8):442-448doi: 10.1179/1607845414Y.0000000228.
Mytelka, D. S., Li, L., Stafkey-Mailey, D., Liepa, A. M., Hess, L. M., Farrelly, E., & Eaddy, M. (2015). Treatment patterns and outcomes among patients with high-intermediate/high-risk diffuse large B-cell lymphoma in the USA. Hematology (Amsterdam, Netherlands), 20(8), 442-448. https://doi.org/10.1179/1607845414Y.0000000228
Mytelka, Daniel S, et al. "Treatment patterns and outcomes among patients with high-intermediate/high-risk diffuse large B-cell lymphoma in the USA." Hematology (Amsterdam, Netherlands) vol. 20,8 (2015): 442-448. doi: https://doi.org/10.1179/1607845414Y.0000000228
Mytelka DS, Li L, Stafkey-Mailey D, Liepa AM, Hess LM, Farrelly E, Eaddy M. Treatment patterns and outcomes among patients with high-intermediate/high-risk diffuse large B-cell lymphoma in the USA. Hematology. 2015 Sep;20(8):442-448. doi: 10.1179/1607845414Y.0000000228. Epub 2014 Dec 31. PMID: 25551431.
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Hematology. 2015 Sep;20(8):442-448. doi: 10.1179/1607845414Y.0000000228. Epub 2014 Dec 31.

Treatment patterns and outcomes among patients with high-intermediate/high-risk diffuse large B-cell lymphoma in the USA.

Hematology (Amsterdam, Netherlands)

Daniel S Mytelka, Li Li, Dana Stafkey-Mailey, Astra M Liepa, Lisa M Hess, Eileen Farrelly, Michael Eaddy

Affiliations

  1. a Eli Lilly and Company Indianapolis , IN , USA.
  2. b Xcenda Palm Harbor , FL , USA.

PMID: 25551431 DOI: 10.1179/1607845414Y.0000000228

Abstract

Objective Clinical trials have demonstrated improved outcomes for patients with diffuse large B-cell lymphoma (DLBCL) treated with regimens containing rituximab, but variations in real-world treatment patterns and outcomes have not been studied. The objective of this study was to characterize real-world treatment patterns and outcomes in higher risk DLBCL patients. Methods Patients with an International Prognostic Index score (IPI) ≥3 who received initial rituximab-based therapy from 2005 to 2012 were identified via electronic medical record data from the International Oncology Network. Initial therapy, rates of complete response (CR), post-CR treatments, and outcomes were evaluated. Results Among 257 eligible patients, 75% achieved a CR: 77% (158/206) of patients receiving R-CHOP compared to 71% (36/51) of patients receiving initial therapies other than R-CHOP. Post-CR, 78% of the 158 patients receiving R-CHOP underwent active surveillance; 13% received maintenance rituximab-based treatment; and 6% received radiation therapy. Relapse rates among patients receiving maintenance rituximab, active surveillance, and radiation therapy were 28% (6/21), 19% (24/124), and 0%, (0/10), respectively (P = 0.08). Discussion This study found that active surveillance continues to be the most commonly utilized treatment regimen among DLBCL patients with an IPI score ≥3 achieving a CR on first-line R-CHOP. Other approaches aimed at increasing the time to relapse are being utilized as well, but the clinical benefit of these modalities is unclear. Conclusion Results of this study are consistent with the results from clinical trials and suggest the need for further evaluation of maintenance therapy options for patients at higher risk of relapse.

Keywords: DLBCL; Lymphoma; Maintenance; NHL; Real-world; Treatment patterns

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