Significant reduced loss of bone mineral density after four vs. six cycles of R-CHOP: an analysis of the FLYER-trial.

Abstract

Patients with diffuse large B-cell lymphoma (DLBCL) treated with the R-CHOP regime receive a high cumulative dose of prednisone. We used computer tomography-ascertained Hounsfield units (HU) as a surrogate parameter for bone mineral density (BMD) in three different locations of the L3 vertebral body at baseline and post-treatment. HU were measured in 50 patients with DLBCL of the previously published FLYER-trial which compared four cycles of R-CHOP + 2 × rituximab infusion to six cycles of R-CHOP in young, favorable DLBCL patients. In total, median loss was 26.8 HU in all patients over time. The median HU loss was significantly lower in the four cycles arm (21.3 HU vs. 41.3 HU, p = 0.023). In conclusion, young patients with DLBCL receiving R-CHOP have significant HU/BMD loss under treatment with R-CHOP. Patients receiving four cycles of R-CHOP had less HU/BMD loss than patients receiving six cycles.

• Authors: Dominic Kaddu-Mulindwa, Vadim Lesan, Christian Berdel, Stephan Stilgenbauer, Moritz Bewarder, Lorenz Thurner, Mathias Witzens-Harig, Andreas Viardot, Martin Soekler, Ulrich Keller, Lorenz Truemper, Konstantinos Christofyllakis, Octavian Fleser, Joerg Thomas Bittenbring, Viola Poeschel, Gerhard Held, Philippe Jagoda
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 63 Issue 2 Pg. 326-334 (02 2022) ISSN: 1029-2403 [Electronic] United States
• PMID: 34668817 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Bone Density
• Cyclophosphamide (therapeutic use)
• Doxorubicin (therapeutic use)
• Humans
• Lymphoma, Large B-Cell, Diffuse (diagnosis, drug therapy, etiology)
• Prednisone (adverse effects)
• Rituximab
• Vincristine (adverse effects)