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Annals of Oncology 4:651-656, 1993
© 1993 European Society for Medical Oncology

research-article

Prognostic significance of received relative dose intensity in non-Hodgkin's lymphoma patients: Application to LNH-87 protocol

E. Lepage1,, C. Gisselbrecht2, C. Haioun3, C. Sebban4, H. Tilly5, A. Bosly6, P. Morel7, R. Herbrecht8, F. Reyes3 and B. Coiffier9

1Départment de Biostatistique et Informatique Médicate
2Département d'Hématologie, Hôpital Saint-Louis Paris
3Service d'Hématologie, Hôpital Henri-Mondor Creteil
4Service d'Hématologie, Hôpital Edouard-Herriot Lyon
5Service d'Hématologie, Centre Henri-Bequerel Rouen, France
6Service d'Hématologie, Université de Louvain Yvoir, Belgique
7Service des Maladies du Sang, Hôpital Calmette Lille
8Service d'Hématologie, Hôpital Hautepierre Strasbourg
9Service d'Hématologie, Centre Hospitaller Lyon-Sud Pierre-Benite, France

Correspondence to: Eric Lepage, M.D,phD Départment de Biostatisque et information Médicale Hôspital Saint-Louis J Avenue Claude vellefaux 75010 paris, France

Background: To evaluate the effects of chemotherapy dose intensity (DI) on outcome in patients with aggressive lymphoma, the received relative DI (received RDI) is usually calculated using Hryniuk's model. We applied this model to a selected patient subgroup included in the LNH87 protocol (LNH87-2 protocol), who had been treated with the ACVB induction regimen.

Patients and methods: Patients aged ±55 who had at least one of the following prognostic factors: performance status (PS) ≥2, number of extranodal sites ≥2, tumor burden ≥10 cm, bone marrow or central nervous system involvement, and Burkitt's or lymphoblastic histologic subtype, were included in this study. Actual DI was calculated using the definition of DI as mg/m2/week previously described by Hryniuk.

Results: Eighty-seven of the 311 patients included in the study (28%) presented a RDI below 70% of the theoretical DI. We demonstrated a decreased response rate (65% vs. 79%, p = 0.01) and shorter overall 2-year survival (61% vs. 72%, p = 0.02) in patients receiving a DI ±70%. This difference was still significant when the multiparametric analysis was used (p = 0.004).

Conclusion: Results obtained when this model was applied to aggressive lyhoma patients included in the LNH-87 protocol led to the demonstration of a strong relationship between received RDI and survival.

non-Hodgkin's lymphoma, dose intensity, LNH-87 protocol


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