Chemotherapy delivery time affects treatment outcomes of female patients with diffuse large B cell lymphoma

• DOI: 10.1172/jci.insight.164767
• Publication Date: 2022-12-13T17:01:07Z
• Authors: Dae Wook Kim; Ja Min Byun; Jeong-Ok Lee; Jae Kyoung Kim; Youngil Koh
• Keywords: Tolerability

BACKGROUNDChronotherapy is a drug intervention at specific times of the day to optimize efficacy and minimize adverse effects. Its value in hematologic malignancy remains be explored, particular adult patients.METHODSWe performed chronotherapeutic analysis using 2 cohorts patients with diffuse large B cell lymphoma (DLBCL) undergoing chemotherapy dichotomized schedule (morning or afternoon). The effect morning afternoon rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) on survival tolerability was evaluated cohort (n = 210) an event 129), respectively. Analysis about 14,000 healthy individuals followed identify circadian variation parameters.RESULTSBoth progression-free (PFS) overall (OS) female, but not male, were significantly shorter when received mostly (PFS HR 0.357, P 0.033; OS 0.141, 0.032). dose intensity reduced female treated (cyclophosphamide 10%, 0.002; doxorubicin 8%, 7%, 0.003). This mainly attributable infection neutropenic fever: had higher incidence infections (16.7% vs. 2.4%) febrile neutropenia (20.8% 9.8%) as compared those afternoon. sex-specific effects can explained by larger daily fluctuation circulating leukocytes neutrophils than male patients.CONCLUSIONIn DLBCL patients, R-CHOP treatment reduce toxicity while it improves outcome.FUNDINGNational Research Foundation Korea (NRF) grant funded Korean government (grant number NRF-2021R1A4A2001553), Institute for Basic Science IBS-R029-C3, Human Frontiers Program Organization Grant RGY0063/2017.