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Preparation of Primary Acute Lymphoblastic Leukemia Cells in Different Cell Cycle Phases by Centrifugal Elutriation
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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.

Journal of the Egyptian National Cancer Institute
|May 8, 2022
PubMed
Summary
This summary is machine-generated.

Pre-phase treatment with vincristine and prednisolone significantly improves performance status and reduces febrile neutropenia in diffuse large B cell lymphoma (DLBCL) patients. This approach alleviates early treatment toxicities, enhancing patient outcomes.

Keywords:
DLBCLFirst cycle effectPre-phase

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Area of Science:

  • Hematology
  • Oncology
  • Clinical Trials

Background:

  • Diffuse large B cell lymphoma (DLBCL) patients experience high treatment-related toxicities, particularly during the initial treatment phase (first cycle effect).
  • Previous non-randomized studies suggested pre-phase treatment could mitigate these early side-effects.

Purpose of the Study:

  • To prospectively validate the efficacy of pre-phase treatment in newly diagnosed DLBCL patients.
  • To assess the impact of pre-phase therapy on patient performance status and neutropenia rates.

Main Methods:

  • A single-arm prospective study enrolled 180 newly diagnosed DLBCL patients aged over 18.
  • Patients received 7 days of vincristine and prednisolone pre-phase treatment before initiating definitive chemotherapy.
  • Follow-up included assessment of clinical variables and toxicity for 30 days post-first chemotherapy cycle.

Main Results:

  • Significant improvement in Eastern Cooperative Oncology Group (ECOG) performance status was observed, with 38.4% of patients achieving ECOG 0 post-pre-phase therapy (p < 0.001).
  • Febrile neutropenia incidence was markedly reduced to 12.8% compared to a historical cohort (34%).

Conclusions:

  • Pre-phase therapy with vincristine and prednisolone is an effective strategy to improve performance status in DLBCL patients.
  • This regimen significantly diminishes the incidence of neutropenia, thereby reducing early treatment-related toxicities.