Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features

Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituxi...
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Autor*in:	Dholaria, Bhagirathbhai [verfasserIn] Vanegas, Yenny Alejandra Moreno Diehl, Nancy Spaulding, Aaron C. Visscher, Sue Tun, Han W. Ailawadhi, Sikander Vishnu, Prakash

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Diffuse large B-cell lymphoma chemotherapy outcomes research combined antineoplastic chemotherapy protocols

Anmerkung:	© International Academy for Clinical Hematology 2020

Übergeordnetes Werk:	Enthalten in: Clinical hematology international - Paris : Atlantis Press, 2019, 2(2020), 3 vom: 23. Apr., Seite 117-124
Übergeordnetes Werk:	volume:2 ; year:2020 ; number:3 ; day:23 ; month:04 ; pages:117-124

Links:	Volltext

DOI / URN:	10.2991/chi.d.200410.001

Katalog-ID:	SPR054881315

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allfields	10.2991/chi.d.200410.001 doi (DE-627)SPR054881315 (SPR)chi.d.200410.001-e DE-627 ger DE-627 rakwb eng Dholaria, Bhagirathbhai verfasserin (orcid)0000-0003-2371-3655 aut Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © International Academy for Clinical Hematology 2020 Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. Diffuse large B-cell lymphoma (dpeaa)DE-He213 chemotherapy (dpeaa)DE-He213 outcomes research (dpeaa)DE-He213 combined antineoplastic chemotherapy protocols (dpeaa)DE-He213 Vanegas, Yenny Alejandra Moreno (orcid)0000-0002-4927-1237 aut Diehl, Nancy aut Spaulding, Aaron C. (orcid)0000-0001-9727-6756 aut Visscher, Sue aut Tun, Han W. aut Ailawadhi, Sikander (orcid)0000-0002-8377-8111 aut Vishnu, Prakash aut Enthalten in Clinical hematology international Paris : Atlantis Press, 2019 2(2020), 3 vom: 23. Apr., Seite 117-124 (DE-627)1682374505 (DE-600)3000786-0 2590-0048 nnns volume:2 year:2020 number:3 day:23 month:04 pages:117-124 https://dx.doi.org/10.2991/chi.d.200410.001 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 3 23 04 117-124
spelling	10.2991/chi.d.200410.001 doi (DE-627)SPR054881315 (SPR)chi.d.200410.001-e DE-627 ger DE-627 rakwb eng Dholaria, Bhagirathbhai verfasserin (orcid)0000-0003-2371-3655 aut Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © International Academy for Clinical Hematology 2020 Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. Diffuse large B-cell lymphoma (dpeaa)DE-He213 chemotherapy (dpeaa)DE-He213 outcomes research (dpeaa)DE-He213 combined antineoplastic chemotherapy protocols (dpeaa)DE-He213 Vanegas, Yenny Alejandra Moreno (orcid)0000-0002-4927-1237 aut Diehl, Nancy aut Spaulding, Aaron C. (orcid)0000-0001-9727-6756 aut Visscher, Sue aut Tun, Han W. aut Ailawadhi, Sikander (orcid)0000-0002-8377-8111 aut Vishnu, Prakash aut Enthalten in Clinical hematology international Paris : Atlantis Press, 2019 2(2020), 3 vom: 23. Apr., Seite 117-124 (DE-627)1682374505 (DE-600)3000786-0 2590-0048 nnns volume:2 year:2020 number:3 day:23 month:04 pages:117-124 https://dx.doi.org/10.2991/chi.d.200410.001 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 3 23 04 117-124
allfields_unstemmed	10.2991/chi.d.200410.001 doi (DE-627)SPR054881315 (SPR)chi.d.200410.001-e DE-627 ger DE-627 rakwb eng Dholaria, Bhagirathbhai verfasserin (orcid)0000-0003-2371-3655 aut Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © International Academy for Clinical Hematology 2020 Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. Diffuse large B-cell lymphoma (dpeaa)DE-He213 chemotherapy (dpeaa)DE-He213 outcomes research (dpeaa)DE-He213 combined antineoplastic chemotherapy protocols (dpeaa)DE-He213 Vanegas, Yenny Alejandra Moreno (orcid)0000-0002-4927-1237 aut Diehl, Nancy aut Spaulding, Aaron C. (orcid)0000-0001-9727-6756 aut Visscher, Sue aut Tun, Han W. aut Ailawadhi, Sikander (orcid)0000-0002-8377-8111 aut Vishnu, Prakash aut Enthalten in Clinical hematology international Paris : Atlantis Press, 2019 2(2020), 3 vom: 23. Apr., Seite 117-124 (DE-627)1682374505 (DE-600)3000786-0 2590-0048 nnns volume:2 year:2020 number:3 day:23 month:04 pages:117-124 https://dx.doi.org/10.2991/chi.d.200410.001 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 3 23 04 117-124
allfieldsGer	10.2991/chi.d.200410.001 doi (DE-627)SPR054881315 (SPR)chi.d.200410.001-e DE-627 ger DE-627 rakwb eng Dholaria, Bhagirathbhai verfasserin (orcid)0000-0003-2371-3655 aut Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © International Academy for Clinical Hematology 2020 Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. Diffuse large B-cell lymphoma (dpeaa)DE-He213 chemotherapy (dpeaa)DE-He213 outcomes research (dpeaa)DE-He213 combined antineoplastic chemotherapy protocols (dpeaa)DE-He213 Vanegas, Yenny Alejandra Moreno (orcid)0000-0002-4927-1237 aut Diehl, Nancy aut Spaulding, Aaron C. (orcid)0000-0001-9727-6756 aut Visscher, Sue aut Tun, Han W. aut Ailawadhi, Sikander (orcid)0000-0002-8377-8111 aut Vishnu, Prakash aut Enthalten in Clinical hematology international Paris : Atlantis Press, 2019 2(2020), 3 vom: 23. Apr., Seite 117-124 (DE-627)1682374505 (DE-600)3000786-0 2590-0048 nnns volume:2 year:2020 number:3 day:23 month:04 pages:117-124 https://dx.doi.org/10.2991/chi.d.200410.001 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 3 23 04 117-124
allfieldsSound	10.2991/chi.d.200410.001 doi (DE-627)SPR054881315 (SPR)chi.d.200410.001-e DE-627 ger DE-627 rakwb eng Dholaria, Bhagirathbhai verfasserin (orcid)0000-0003-2371-3655 aut Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © International Academy for Clinical Hematology 2020 Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. Diffuse large B-cell lymphoma (dpeaa)DE-He213 chemotherapy (dpeaa)DE-He213 outcomes research (dpeaa)DE-He213 combined antineoplastic chemotherapy protocols (dpeaa)DE-He213 Vanegas, Yenny Alejandra Moreno (orcid)0000-0002-4927-1237 aut Diehl, Nancy aut Spaulding, Aaron C. (orcid)0000-0001-9727-6756 aut Visscher, Sue aut Tun, Han W. aut Ailawadhi, Sikander (orcid)0000-0002-8377-8111 aut Vishnu, Prakash aut Enthalten in Clinical hematology international Paris : Atlantis Press, 2019 2(2020), 3 vom: 23. Apr., Seite 117-124 (DE-627)1682374505 (DE-600)3000786-0 2590-0048 nnns volume:2 year:2020 number:3 day:23 month:04 pages:117-124 https://dx.doi.org/10.2991/chi.d.200410.001 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 3 23 04 117-124
language	English
source	Enthalten in Clinical hematology international 2(2020), 3 vom: 23. Apr., Seite 117-124 volume:2 year:2020 number:3 day:23 month:04 pages:117-124
sourceStr	Enthalten in Clinical hematology international 2(2020), 3 vom: 23. Apr., Seite 117-124 volume:2 year:2020 number:3 day:23 month:04 pages:117-124
format_phy_str_mv	Article
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topic_facet	Diffuse large B-cell lymphoma chemotherapy outcomes research combined antineoplastic chemotherapy protocols
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authorswithroles_txt_mv	Dholaria, Bhagirathbhai @@aut@@ Vanegas, Yenny Alejandra Moreno @@aut@@ Diehl, Nancy @@aut@@ Spaulding, Aaron C. @@aut@@ Visscher, Sue @@aut@@ Tun, Han W. @@aut@@ Ailawadhi, Sikander @@aut@@ Vishnu, Prakash @@aut@@
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author	Dholaria, Bhagirathbhai
spellingShingle	Dholaria, Bhagirathbhai misc Diffuse large B-cell lymphoma misc chemotherapy misc outcomes research misc combined antineoplastic chemotherapy protocols Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features
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topic_title	Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features Diffuse large B-cell lymphoma (dpeaa)DE-He213 chemotherapy (dpeaa)DE-He213 outcomes research (dpeaa)DE-He213 combined antineoplastic chemotherapy protocols (dpeaa)DE-He213
topic	misc Diffuse large B-cell lymphoma misc chemotherapy misc outcomes research misc combined antineoplastic chemotherapy protocols
topic_unstemmed	misc Diffuse large B-cell lymphoma misc chemotherapy misc outcomes research misc combined antineoplastic chemotherapy protocols
topic_browse	misc Diffuse large B-cell lymphoma misc chemotherapy misc outcomes research misc combined antineoplastic chemotherapy protocols
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title	Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features
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title_full	Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features
author_sort	Dholaria, Bhagirathbhai
journal	Clinical hematology international
journalStr	Clinical hematology international
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author_browse	Dholaria, Bhagirathbhai Vanegas, Yenny Alejandra Moreno Diehl, Nancy Spaulding, Aaron C. Visscher, Sue Tun, Han W. Ailawadhi, Sikander Vishnu, Prakash
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author-letter	Dholaria, Bhagirathbhai
doi_str_mv	10.2991/chi.d.200410.001
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title_sort	cost analysis of r-chop versus dose-adjusted r-epoch in treatment of diffuse large b-cell lymphoma with high-risk features
title_auth	Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features
abstract	Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. © International Academy for Clinical Hematology 2020
abstractGer	Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. © International Academy for Clinical Hematology 2020
abstract_unstemmed	Abstract Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohisto-chemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range:0.7–151.3 months).The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%–2.29%, p = 0.67] and 0.86 (95% CI 0.26%–2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL. © International Academy for Clinical Hematology 2020
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title_short	Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features
url	https://dx.doi.org/10.2991/chi.d.200410.001
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author2	Vanegas, Yenny Alejandra Moreno Diehl, Nancy Spaulding, Aaron C. Visscher, Sue Tun, Han W. Ailawadhi, Sikander Vishnu, Prakash
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up_date	2024-07-04T03:22:10.188Z
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