Early Complete Response after Chemotherapy as A Prognostic Indicator for Final Outcome in High Grade Non-Hodgkin’s Lymphoma Patients
EL Agamawy, A., Zekry, M., Nayel, H., Mohamed, E. (2019). Early Complete Response after Chemotherapy as A Prognostic Indicator for Final Outcome in High Grade Non-Hodgkin’s Lymphoma Patients. EKB Journal Management System, 74(5), 1053-1063. doi: 10.21608/ejhm.2019.26353
Ahmed Yousery EL Agamawy; Mohsen Salah El Din Zekry; Hala Abd El Badie Nayel; Eslam Mohamed Mohamed. "Early Complete Response after Chemotherapy as A Prognostic Indicator for Final Outcome in High Grade Non-Hodgkin’s Lymphoma Patients". EKB Journal Management System, 74, 5, 2019, 1053-1063. doi: 10.21608/ejhm.2019.26353
EL Agamawy, A., Zekry, M., Nayel, H., Mohamed, E. (2019). 'Early Complete Response after Chemotherapy as A Prognostic Indicator for Final Outcome in High Grade Non-Hodgkin’s Lymphoma Patients', EKB Journal Management System, 74(5), pp. 1053-1063. doi: 10.21608/ejhm.2019.26353
EL Agamawy, A., Zekry, M., Nayel, H., Mohamed, E. Early Complete Response after Chemotherapy as A Prognostic Indicator for Final Outcome in High Grade Non-Hodgkin’s Lymphoma Patients. EKB Journal Management System, 2019; 74(5): 1053-1063. doi: 10.21608/ejhm.2019.26353

Early Complete Response after Chemotherapy as A Prognostic Indicator for Final Outcome in High Grade Non-Hodgkin’s Lymphoma Patients

The Egyptian Journal of Hospital Medicine
Article 13, Volume 74, Issue 5, January 2019, Page 1053-1063  XML PDF (495.69 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2019.26353
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Authors
Ahmed Yousery EL Agamawy1; Mohsen Salah El Din Zekry1; Hala Abd El Badie Nayel2; Eslam Mohamed Mohamed email 1
1Clinical Oncology And Nuclear Medicine Department, Faculty Of Medicine, Al-Azhar University
2Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Faculty Of Medicine, Cairo University, Cairo, Egypt
Abstract
Background: In spite of progress in management of high-grade Non-Hodgkin’s Lymphoma (NHL), more than 30% will ultimately relapse after standard treatment. Aim of study: was to estimate early complete response (CR) as a prognostic factor for final outcome and benefit of early switching to second line chemotherapy for slow responders. Patients and Method: Newly diagnosed patients with high-grade NHL were randomized to either Group A or Group B. All patients received 3 cycles of CHOP/RCHOP while, only patients in the group B who didn't achieve early CR were shifted to second line chemotherapy. Results: The clinicopathological characteristics of patients included in the two groups were comparable. Assessment of treatment results after the 6th cycle showed that 10 patients achieved late CR, 4 patients in group A (40%-4/10) and 6 patients in group B (6/7–85.7%). This difference was statistically significant (p-value 0.04). Out of the early CR group (24 patients), one patient died and another developed CNS relapse thus, both mortality (1/24) and relapse rate (1/23) of early CR group is 4%. Two patients of late CR group relapse (2/10-20%). The difference between the relapse rates of early CR (4%) and late CR (20%) wasn't statistically significant. The remaining 22 patients (22/23-95.7%) achieved early CR and 8 achieved late CR (8/10-80%) were in maintained remission. Regarding toxicity profile, there was no significant difference between both groups.
Conclusion: Early shifting to second-line chemotherapy is tolerable and promising. However, studies with larger number of patients are mandatory to identify who may need this approach.
Keywords
NHLs; early complete response and shifting to second line in NHLs
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