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
ISSN0902-4441
DOIs
Publication statusPublished - 2024

Bibliographical note

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

Keywords

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

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