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- W2340809549 abstract "20527 Background: Inflammatory or B symptoms are associated with worse treatment response & survival. B symptoms are associated with elevated plasma inflammatory markers including C-reactive protein (CRP), lactate dehydrogenase (LDH) & pro-inflammatory cytokines. The majority of cytotoxic agents are metabolised by the liver. Elevated inflammatory markers have been associated with reduced hepatic drug metabolism. Recent data suggest that cancer associated inflammation reduces hepatic metabolism of cytotoxic drugs leading to increased toxicity. Methods: BNLI compared two chemotherapy regimens (CHOP or PMitCEBO) in 784 older patients with aggressive NHL. Data was reanalysed to compare toxicities & tumour response rates (chi-square & Fisher exact tests), and survival (log-rank test) for patients with & without B symptoms. Results: Patients with B symptoms (54%, n=412) had significantly higher International Prognostic Index scores, disease stage, LDH levels & performance status than those without (p<0.05). Response rate for patients with B symptoms was 87% significantly lower for patients without B symptoms (92%) (OR 1.8, 95% CI: 1.05 - 2.91, p<0.05). After median of 44 months follow-up, the presence of B symptoms resulted in a shorter failure free survival of 1.3 yrs (95% CI: 0.88 - 1.72) vs. 3.6 yrs (95% CI: 1.71 - 5.47, p<0.001), & median overall survival 1.75 yrs (95% CI: 1.27 - 2.23) vs.4.4 yrs (95% CI: 2.89 - 5.91 yrs, p<0.001). Haematological toxicity was significantly worse in patients with B symptoms compared to those without; grades 3–4 leucopenia 57% vs. 40% (p<0.001), anaemia 10% vs. 5% (p<0.001), thrombocytopenia 14% vs. 6% (p<0.001). Grades 3–4 infection occurred in 26% of patients with B symptoms compared to 10% without (p<0.05). Median duration of hospitalisation was 10 days for patients with B symptoms and 5 days for those without (p<0.05). Conclusions: Inflammatory symptoms predict for worse toxicity from chemotherapy in patients with NHL. No significant financial relationships to disclose." @default.
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- W2340809549 date "2008-05-20" @default.
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- W2340809549 title "Use of inflammatory symptoms to predict worse myelosuppression in aggressive non-Hodgkin lymphoma (NHL): Reanalysis of British National Lymphoma Institute (BNLI) study of CHOP versus PMitCEBO with or without granulocyte colony stimulating factor" @default.
- W2340809549 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.20527" @default.
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