Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma
Vincent J. Picozzi, Brad L. Pohlman, Vicki A. Morrison, Grant D. Lawless, Martin W. Lee, Robert O. Kerr, Jon M. Ford, David J. Delgado, Moshe Fridman, William B. Carter
Medicine - Hematology, Oncology, Transplant
Records from 653 patients treated between 1991 and 1998 in the Oncology Practice Patterns Study (OPPS) were analyzed to determine contemporary chemotherapy delivery patterns in patients with intermediate-grade non-Hodgkin's lymphoma (NHL). Of the 653 patient records reviewed, 90 (14%) omitted an anthracycline or mitoxantrone (Novantrone) from primary therapy. Among patients receiving CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) or CNOP (cyclophosphamide, mitoxantrone, vincristine, prednisone), 134 (27%) of 492 received an average relative dose intensity of less than 80% of the literature-referenced dose, due either to an inadequate planned or delivered dose. Of 181 advanced-stage patients with responsive disease, 28 (15%) failed to receive at least six treatment cycles. Overall, 283 (43%) of 653 patients potentially received suboptimal chemotherapy due either to choice of regimen or chemotherapy delivered. Patient age ≥ 65 y ears and cardiac comorbidity appeared to have the greatest influence on a physician's decision regarding chemotherapy administration. Among the 492 patients who received CHOP or CNOP, 235 (48%) experienced a delay or reduction in chemotherapy dose (usually neutropenia-related), 100 (20%) developed mucositis, and 116 (24%) were hospitalized for febrile neutropenia. Growth factor was administered to 261 patients (53%), and its primary prophylactic use was associated with a significant reduction in the incidence of hospitalizations for febrile neutropenia in all patient subgroups receiving appropriate chemotherapeutic dose intensity (P = .02). This assessment of chemotherapy delivery to patients with intermediate-grade NHL showed significant variation from current standards. Further analysis of factors influencing chemotherapy delivery might improve therapeutic outcomes.
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Non-Hodgkin's Lymphoma Medicine & Life Sciences
Cyclophosphamide Medicine & Life Sciences
Drug Therapy Medicine & Life Sciences
Vincristine Medicine & Life Sciences
Mitoxantrone Medicine & Life Sciences
Prednisone Medicine & Life Sciences
Febrile Neutropenia Medicine & Life Sciences
Doxorubicin Medicine & Life Sciences
Picozzi, V. J., Pohlman, B. L., Morrison, V. A., Lawless, G. D., Lee, M. W., Kerr, R. O., Ford, J. M., Delgado, D. J., Fridman, M., & Carter, W. B. (2001). Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma. ONCOLOGY, 15(10), 1296-1306.
Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma. / Picozzi, Vincent J.; Pohlman, Brad L.; Morrison, Vicki A.; Lawless, Grant D.; Lee, Martin W.; Kerr, Robert O.; Ford, Jon M.; Delgado, David J.; Fridman, Moshe; Carter, William B.
In: ONCOLOGY, Vol. 15, No. 10, 2001, p. 1296-1306.
Picozzi, VJ, Pohlman, BL, Morrison, VA, Lawless, GD, Lee, MW, Kerr, RO, Ford, JM, Delgado, DJ, Fridman, M & Carter, WB 2001, 'Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma', ONCOLOGY, vol. 15, no. 10, pp. 1296-1306.
Picozzi VJ, Pohlman BL, Morrison VA, Lawless GD, Lee MW, Kerr RO et al. Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma. ONCOLOGY. 2001;15(10):1296-1306.
Picozzi, Vincent J. ; Pohlman, Brad L. ; Morrison, Vicki A. ; Lawless, Grant D. ; Lee, Martin W. ; Kerr, Robert O. ; Ford, Jon M. ; Delgado, David J. ; Fridman, Moshe ; Carter, William B. / Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma. In: ONCOLOGY. 2001 ; Vol. 15, No. 10. pp. 1296-1306.
@article{c5e233e61b2149c899bf70fd4980c429,
title = "Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma",
abstract = "Records from 653 patients treated between 1991 and 1998 in the Oncology Practice Patterns Study (OPPS) were analyzed to determine contemporary chemotherapy delivery patterns in patients with intermediate-grade non-Hodgkin's lymphoma (NHL). Of the 653 patient records reviewed, 90 (14%) omitted an anthracycline or mitoxantrone (Novantrone) from primary therapy. Among patients receiving CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) or CNOP (cyclophosphamide, mitoxantrone, vincristine, prednisone), 134 (27%) of 492 received an average relative dose intensity of less than 80% of the literature-referenced dose, due either to an inadequate planned or delivered dose. Of 181 advanced-stage patients with responsive disease, 28 (15%) failed to receive at least six treatment cycles. Overall, 283 (43%) of 653 patients potentially received suboptimal chemotherapy due either to choice of regimen or chemotherapy delivered. Patient age ≥ 65 y ears and cardiac comorbidity appeared to have the greatest influence on a physician's decision regarding chemotherapy administration. Among the 492 patients who received CHOP or CNOP, 235 (48%) experienced a delay or reduction in chemotherapy dose (usually neutropenia-related), 100 (20%) developed mucositis, and 116 (24%) were hospitalized for febrile neutropenia. Growth factor was administered to 261 patients (53%), and its primary prophylactic use was associated with a significant reduction in the incidence of hospitalizations for febrile neutropenia in all patient subgroups receiving appropriate chemotherapeutic dose intensity (P = .02). This assessment of chemotherapy delivery to patients with intermediate-grade NHL showed significant variation from current standards. Further analysis of factors influencing chemotherapy delivery might improve therapeutic outcomes.",
author = "Picozzi, {Vincent J.} and Pohlman, {Brad L.} and Morrison, {Vicki A.} and Lawless, {Grant D.} and Lee, {Martin W.} and Kerr, {Robert O.} and Ford, {Jon M.} and Delgado, {David J.} and Moshe Fridman and Carter, {William B.}",
journal = "Oncology",
publisher = "UBM Medica Healthcare Publications",
T1 - Patterns of chemotherapy administration in patients with intermediate-grade non-hodgkin's lymphoma
AU - Picozzi, Vincent J.
AU - Pohlman, Brad L.
AU - Morrison, Vicki A.
AU - Lawless, Grant D.
AU - Lee, Martin W.
AU - Kerr, Robert O.
AU - Ford, Jon M.
AU - Delgado, David J.
AU - Fridman, Moshe
AU - Carter, William B.
N2 - Records from 653 patients treated between 1991 and 1998 in the Oncology Practice Patterns Study (OPPS) were analyzed to determine contemporary chemotherapy delivery patterns in patients with intermediate-grade non-Hodgkin's lymphoma (NHL). Of the 653 patient records reviewed, 90 (14%) omitted an anthracycline or mitoxantrone (Novantrone) from primary therapy. Among patients receiving CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) or CNOP (cyclophosphamide, mitoxantrone, vincristine, prednisone), 134 (27%) of 492 received an average relative dose intensity of less than 80% of the literature-referenced dose, due either to an inadequate planned or delivered dose. Of 181 advanced-stage patients with responsive disease, 28 (15%) failed to receive at least six treatment cycles. Overall, 283 (43%) of 653 patients potentially received suboptimal chemotherapy due either to choice of regimen or chemotherapy delivered. Patient age ≥ 65 y ears and cardiac comorbidity appeared to have the greatest influence on a physician's decision regarding chemotherapy administration. Among the 492 patients who received CHOP or CNOP, 235 (48%) experienced a delay or reduction in chemotherapy dose (usually neutropenia-related), 100 (20%) developed mucositis, and 116 (24%) were hospitalized for febrile neutropenia. Growth factor was administered to 261 patients (53%), and its primary prophylactic use was associated with a significant reduction in the incidence of hospitalizations for febrile neutropenia in all patient subgroups receiving appropriate chemotherapeutic dose intensity (P = .02). This assessment of chemotherapy delivery to patients with intermediate-grade NHL showed significant variation from current standards. Further analysis of factors influencing chemotherapy delivery might improve therapeutic outcomes.
AB - Records from 653 patients treated between 1991 and 1998 in the Oncology Practice Patterns Study (OPPS) were analyzed to determine contemporary chemotherapy delivery patterns in patients with intermediate-grade non-Hodgkin's lymphoma (NHL). Of the 653 patient records reviewed, 90 (14%) omitted an anthracycline or mitoxantrone (Novantrone) from primary therapy. Among patients receiving CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) or CNOP (cyclophosphamide, mitoxantrone, vincristine, prednisone), 134 (27%) of 492 received an average relative dose intensity of less than 80% of the literature-referenced dose, due either to an inadequate planned or delivered dose. Of 181 advanced-stage patients with responsive disease, 28 (15%) failed to receive at least six treatment cycles. Overall, 283 (43%) of 653 patients potentially received suboptimal chemotherapy due either to choice of regimen or chemotherapy delivered. Patient age ≥ 65 y ears and cardiac comorbidity appeared to have the greatest influence on a physician's decision regarding chemotherapy administration. Among the 492 patients who received CHOP or CNOP, 235 (48%) experienced a delay or reduction in chemotherapy dose (usually neutropenia-related), 100 (20%) developed mucositis, and 116 (24%) were hospitalized for febrile neutropenia. Growth factor was administered to 261 patients (53%), and its primary prophylactic use was associated with a significant reduction in the incidence of hospitalizations for febrile neutropenia in all patient subgroups receiving appropriate chemotherapeutic dose intensity (P = .02). This assessment of chemotherapy delivery to patients with intermediate-grade NHL showed significant variation from current standards. Further analysis of factors influencing chemotherapy delivery might improve therapeutic outcomes.
JO - Oncology
JF - Oncology