Related Experiment Video
Updated: Sep 24, 2025
Preparation of Primary Acute Lymphoblastic Leukemia Cells in Different Cell Cycle Phases by Centrifugal Elutriation
Published on: November 10, 2017
Pre-phase strategy to mitigate first cycle effect in diffuse large B cell lymphoma
A H Rudresha1, Syed Adil Hassan1, A Sreevalli1
1Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M H Marigowda Rd., Hombegowda Nagar, Bengaluru, Karnataka, 560029, India.
Context:
Treatment-related toxicities in DLBCL (diffuse large B cell lymphoma) patients are higher in the initial phase of treatment (first cycle effect). Implementation of pre-phase treatment before definitive chemotherapy had been shown to alleviate some of these side-effects in a non-randomized study conducted earlier in our institute (Lakshmaiah et. al., Eur J Haematol 100:644-8, 2018).
Aims:
This study was aimed at validating the role of pre-phase treatment in newly diagnosed DLBCL patients.
Settings And Design:
All newly diagnosed patients with DLBCL above the age of 18 years were evaluated for eligibility and prospectively enrolled. A single-arm prospective study was conducted at the Department of Medical Oncology, in our institute from July 2015 to December 2019.
Methods And Material:
Patients received vincristine and prednisolone as pre-phase treatment for 7 days after which definitive chemotherapy was instituted on day 1. They were followed up for 30 days post-first cycle chemotherapy.
Statistical Analysis Used:
Paired Student's t tests and Wilcoxon signed-ranks test were used for comparison of various clinical variables as appropriate. P value of less than 0.05 was considered significant.
Results:
Among the 180 patients who were included in study, performance status improvement was noted in significant number of patients (p < 0.001). 38.4% achieved an ECOG (Eastern Cooperative Oncology Group) performance status of 0 post-pre-phase therapy. Febrile neutropenia was observed in 12.8% in the present cohort as compared to the historical non-pre-phase cohort (34%).
Conclusions:
Pre-phase therapy significantly improves the performance status and diminishes neutropenia rates in DLBCL patients.
