Effectiveness of R-CHOP versus R-CHOEP for treatment of young patients with high-risk diffuse large B-cell lymphoma: A Danish observational population-based study

Rasmus Rask Kragh Jørgensen*, Lasse Hjort Jakobsen, Sandra Eloranta, Karin E Smedby, Robert Schou Pedersen, Judit M Jørgensen, Michael Roost Clausen, Peter Brown, Anne Ortved Gang, Inger-Lise Gade, Thomas Stauffer Larsen, Mats Jerkeman, Tarec Christoffer El-Galaly

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

PURPOSE: Etoposide to standard R-CHOP is used for high-risk diffuse large B-cell lymphoma (DLBCL) in some countries. Due to the lack of randomized trials, a real-world data study using matching methods was used to test the potential effectiveness of R-CHOEP over R-CHOP.

PATIENTS AND METHODS: This study included patients from the Danish Lymphoma Register diagnosed between 2006 and 2020 at the age of 18-60 years with de novo DLBCL and age-adjusted IPI ≥2. R-CHOEP treated patients were matched 1:1 without replacement to R-CHOP treated patients using a hybrid exact and genetic matching technique. Primary endpoints were progression-free survival (PFS) and overall survival (OS).

RESULTS: In total, 396 patients were included; 213 received R-CHOEP and 183 received R-CHOP. Unadjusted 5-year PFS and OS for R-CHOEP were 69% (95% Confidence intervals [CI]; 63%-76%) and 79% (CI;73%-85%) versus 62% (CI;55%-70%) and 76% (CI;69%-82%) for R-CHOP (log-rank test, PFS p = .25 and OS p = .31). A total of 127 patients treated with R-CHOEP were matched to 127 patients treated with R-CHOP. Matching-adjusted 5-year PFS and OS were 65% (CI; 57%-74%) and 79% (CI; 72%-84%) for R-CHOEP versus 63% (CI; 55%-73%) and 79% (CI;72%-87%) for R-CHOP (log-rank test, PFS p = .90 and OS p = .63).

CONCLUSION: The present study did not confirm superiority of R-CHOEP over R-CHOP for young patients with high-risk DLBCL.

Original languageEnglish
Book seriesEuropean Journal of Haematology
Volume113
Issue number5
Pages (from-to)641-650
Number of pages10
ISSN0902-4506
DOIs
Publication statusE-pub ahead of print - 22 Jul 2024

Bibliographical note

© 2024 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.

Keywords

  • DLBCL
  • R-CHOP vs R-CHOEP
  • lymphoma
  • optimizing treatment outcome
  • real world data
  • toxicity after treatment
  • treatment of high-risk patients

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