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.

2.50
Hdl Handle:
http://hdl.handle.net/10541/66161
Title:
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.
Authors:
Clamp, Andrew R; Ryder, W David J; Bhattacharya, Soumo; Pettengell, Ruth; Radford, John A ( 0000-0001-7898-2786 )
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.
Affiliation:
Department of Medical Oncology, Cancer Research UK, University of Manchester, Christie Hospital, Wilmslow Rd., Manchester M20 4BX, UK. Andrew.clamp@christie.nhs.uk
Citation:
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. 2008, 99 (2):253-8 Br. J. Cancer
Journal:
British Journal of Cancer
Issue Date:
22-Jul-2008
URI:
http://hdl.handle.net/10541/66161
DOI:
10.1038/sj.bjc.6604468
PubMed ID:
18594529
Type:
Article
Language:
en
ISSN:
1532-1827
Appears in Collections:
All Paterson Institute for Cancer Research; Medical Oncology; Medical Oncology

Full metadata record

DC FieldValue Language
dc.contributor.authorClamp, Andrew R-
dc.contributor.authorRyder, W David J-
dc.contributor.authorBhattacharya, Soumo-
dc.contributor.authorPettengell, Ruth-
dc.contributor.authorRadford, John A-
dc.date.accessioned2009-04-24T09:26:55Z-
dc.date.available2009-04-24T09:26:55Z-
dc.date.issued2008-07-22-
dc.identifier.citationPatterns 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. 2008, 99 (2):253-8 Br. J. Canceren
dc.identifier.issn1532-1827-
dc.identifier.pmid18594529-
dc.identifier.doi10.1038/sj.bjc.6604468-
dc.identifier.urihttp://hdl.handle.net/10541/66161-
dc.description.abstractThe 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.en
dc.language.isoenen
dc.subjectMortality Patternen
dc.subjectDose Intensityen
dc.subjectPharmacovigilanceen
dc.subjectRandomized Controlled Trial-
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBleomycin-
dc.subject.meshCyclophosphamide-
dc.subject.meshDisease-Free Survival-
dc.subject.meshDoxorubicin-
dc.subject.meshEtoposide-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshGranulocyte Colony-Stimulating Factor-
dc.subject.meshHumans-
dc.subject.meshLymphoma, Non-Hodgkin-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProportional Hazards Models-
dc.subject.meshSurvival Rate-
dc.subject.meshTreatment Outcome-
dc.subject.meshVincristine-
dc.titlePatterns 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.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medical Oncology, Cancer Research UK, University of Manchester, Christie Hospital, Wilmslow Rd., Manchester M20 4BX, UK. Andrew.clamp@christie.nhs.uken
dc.identifier.journalBritish Journal of Canceren

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