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Patterns of mortality after prolonged follow-up of a randomised controlled trial using granulocyte colony-stimulating factor to maintain chemotherapy dose intensity in non-Hodgkin's lymphoma

Clamp, AR; Ryder, WD; Bhattacharya, S; Pettengell, R; Radford, JA (2008) Patterns of mortality after prolonged follow-up of a randomised controlled trial using granulocyte colony-stimulating factor to maintain chemotherapy dose intensity in non-Hodgkin's lymphoma. BRITISH JOURNAL OF CANCER, 99 (2). 253 - 258 (6). ISSN 0007-0920 https://doi.org/10.1038/sj.bjc.6604468
SGUL Authors: Pettengell, Ruth

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Abstract

The effect of utilising granulocyte colony-stimulating factor (G-CSF) to maintain chemotherapy dose intensity in non-Hodgkin's lymphoma (NHL) on long-term mortality patterns has not been formally evaluated. We analysed prolonged follow-up data from the first randomised controlled trial investigating this approach. Data on 10-year overall survival (OS), progression-free survival (PFS), freedom from progression (FFP) and incidence of second malignancies were collected for 80 patients with aggressive subtypes of NHL, who had been randomised to receive either VAPEC-B chemotherapy or VAPEC-B+G-CSF. Median follow-up was 15.7 years for surviving patients. No significant differences were found in PFS or OS. However, 10-year FFP was better in the G-CSF arm (68 vs 47%, P=0.037). Eleven deaths from causes unrelated to NHL or its treatment occurred in the G-CSF arm compared to five in controls. More deaths occurred from second malignancies (4 vs 2) and cardiovascular causes (5 vs 0) in the G-CSF arm. Although this pharmacovigilance study has insufficient statistical power to draw conclusions and is limited by the lack of data on smoking history and other cardiovascular risk factors, these unique long-term outcome data generate hypotheses that warrant further investigation.

Item Type: Article
Additional Information: This is a BJC OPEN article made available under a Creative Commons Attribution-Non commercial-Share Alike 3.0 Unported licence. For more information please see http://creativecommons.org/licenses/by-nc-sa/3.0/
Keywords: Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Bleomycin, Cyclophosphamide, Disease-Free Survival, Doxorubicin, Etoposide, Female, Follow-Up Studies, Granulocyte Colony-Stimulating Factor, Humans, Lymphoma, Non-Hodgkin, Male, Middle Aged, Proportional Hazards Models, Survival Rate, Treatment Outcome, Vincristine, Science & Technology, Life Sciences & Biomedicine, Oncology, non-Hodgkin's lymphoma, granulocyte colony-stimulating factor, mortality pattern, dose intensity, pharmacovigilance, second malignancy, 3-WEEKLY CHOP CHEMOTHERAPY, ELDERLY-PATIENTS, PHASE-III, AGGRESSIVE LYMPHOMAS, BRITISH COHORT, DOUBLE-BLIND, 2ND CANCERS, RISK, ETOPOSIDE, PLACEBO, non-Hodgkin's lymphoma, granulocyte colony-stimulating factor, mortality pattern, dose intensity, pharmacovigilance, second malignancy
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: BRITISH JOURNAL OF CANCER
ISSN: 0007-0920
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Dates:
DateEvent
15 July 2008Published
Web of Science ID: WOS:000257647700005
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URI: https://openaccess.sgul.ac.uk/id/eprint/102711
Publisher's version: https://doi.org/10.1038/sj.bjc.6604468

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