ROCHESTER, N.Y., Sept. 20 /PRNewswire/ -- Data from a new study published today online in the Journal of Clinical Oncology demonstrate that approximately half of patients with aggressive and potentially curable non-Hodgkin’s lymphoma (NHL) treated with certain chemotherapy regimens (CHOP, CHOP-R, or CNOP) frequently receive less than the recommended dose and schedule of chemotherapy. Similar results have been observed in a study of nearly 20,000 patients with early-stage breast cancer.
“The data point to a troubling trend in the treatment of patients with aggressive and potentially curable NHL. Far too many patients are not receiving the chemotherapy doses they need in order to have the best chance for remission or cure,” said Gary H. Lyman, M.D., M.P.H., of the James P. Wilmot Cancer Center at the University of Rochester Medical Center and lead author of the study. “Of particular concern is that these results are strikingly similar to those reported late last year in women with early-stage breast cancer, indicating a potential pattern in reductions or delays in chemotherapy across cancer types.”
This comprehensive retrospective analysis of 4,522 patients being treated for aggressive NHL in 567 oncology practices nationwide found that 48 to 53 percent received less than 85 percent of the recommended chemotherapy dose intensity due to treatment delays (24 percent) or dose reductions (40 percent). Despite guidelines recommending six or more cycles of chemotherapy for most NHL patients, the study found that nearly half of all dose reductions were planned in advance of chemotherapy. Previous studies have demonstrated that reductions in the recommended dose intensity can result in lower response and survival rates for patients.
Patients at Most Risk
Elderly cancer patients in this study had more than twice the risk of reduced chemotherapy dose intensity than younger patients. A severely low white blood cell count, or neutropenia, was seen to be the most common treatment-related toxicity associated with reduced dose intensity. When a patient’s white blood cell count drops too low, the patient is at increased risk of infection often delaying treatment until these cells are replenished. In the study, 76 percent of patients who developed infections required hospitalization.
Other significant risk factors for reduced dose intensity included disease stage, performance status, nutritional status and failure to use white cell boosters preventatively to help protect against chemotherapy-induced neutropenia. White blood cell boosters, also known as colony-stimulating factors (CSFs), are available to help reduce the risk of chemotherapy-induced neutropenia, but the study found that only half of patients (54 percent) received them at some point during the course of chemotherapy with only 12 percent initiating these agents preventatively with the first cycle of chemotherapy. Most support was given only after a neutropenic complication had already occurred.
While this study is not slated to be printed in the Journal of Clinical Oncology until November 1, 2004, the journal has released the article early on its Web site, a practice reserved for articles expected to have a “substantial and immediate impact on clinical practice.”
About Lymphoma
Lymphoma is a general term for a group of cancers that originate in the lymphatic system, which defends the body from foreign invasion by disease causing agents such as viruses, bacteria or fungi. The lymphomas are divided into two major categories: Hodgkin’s lymphoma and all other lymphomas, called non-Hodgkin’s lymphoma (NHL). Each year, there are more than 50,000 new cases of non-Hodgkin’s lymphoma diagnosed making it the sixth most common cancer in the United States.
About the ANC Study Group
The Awareness of Neutropenia in Chemotherapy (ANC) Study Group was formed in September 2000 to study further the clinical, economic and quality of life impact of neutropenia on cancer patients and to develop prediction models for neutropenic complications. Directed by three leading U.S. hematologists and oncologists including Gary Lyman, M.D., M.P.H., David Dale, M.D., and Jeffrey Crawford, M.D., the group collaborates with academic and community oncologists throughout the United States. The ANC Study Group receives grant support from Amgen.
Awareness of Neutropenia in Chemotherapy (ANC) Study Group
CONTACT: Christian Pflaumer, +1-212-229-8491 office, +1-917-841-4525cell; Jakob Jakobsen, +1-310-309-1009 office, +1-310-920-8215 cell, forAwareness of Neutropenia in Chemotherapy (ANC) Study Group
