Universität zu Köln

Pfreundschuh, Michael, Mueller, Carsten, Zeynalova, Samira, Kuhnt, Evelyn, Wiesen, Martin H. J., Held, Gerhard, Rixecker, Tanja, Poeschel, Viola, Zwick, Carsten, Reiser, Marcel, Schmitz, Norbert and Murawski, Niels (2014). Suboptimal dosing of rituximab in male and female patients with DLBCL. Blood, 123 (5). S. 640 - 647. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 1528-0020

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Abstract

To determine the effect of gender on outcome, the male hazard ratio for progression-free survival (HRPFS-male) was determined in patients with diffuse large B-cell lymphoma (DLBCL). In young patients (MapThera International Trial study), HRPFS-male was 1.3 (P = .092) without and 1.1 (P = .660) with rituximab. In elderly patients (RICOVER-60 study), HRPFS-male was 1.1 (P = .348) with CHOP but increased to 1.6 (P = .004) with R-CHOP. The similar improvements of outcome in young patients were associated with similar rituximab clearances in young males and females (9.89 vs 10.38 mL/h; P = .238), whereas the greater benefit for elderly females was associated with a slower rituximab clearance (8.47 vs 10.59 mL/h; P = .005) and hence higher serum levels and longer exposure times, attributable to an age-dependent (P = .004) decrease of rituximab clearance in females but not males. Compared with elderly females, all other subgroups had significantly faster rituximab clearances and hence appear to be suboptimally dosed when rituximab is given at 375 mg/m(2). Although early results of pharmacokinetic-based prospective trials designed to exploit the full therapeutic potential of rituximab suggest that increased doses and/or prolonged exposure times can improve the outcome of elderly males with DLBCL, further studies are warranted that address the optimization of rituximab dose and schedule in all subgroups of DLBCL patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pfreundschuh, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeynalova, Samira UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhnt, Evelyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesen, Martin H. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Held, Gerhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Rixecker, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Poeschel, Viola UNSPECIFIED UNSPECIFIED UNSPECIFIED Zwick, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Reiser, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitz, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Murawski, Niels UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-448070
DOI:	10.1182/blood-2013-07-517037
Journal or Publication Title:	Blood
Volume:	123
Number:	5
Page Range:	S. 640 - 647
Date:	2014
Publisher:	AMER SOC HEMATOLOGY
Place of Publication:	WASHINGTON
ISSN:	1528-0020
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language B-CELL LYMPHOMA; CHEMOTHERAPY PLUS RITUXIMAB; RANDOMIZED CONTROLLED-TRIAL; CHOP-LIKE CHEMOTHERAPY; ELDERLY-PATIENTS; PROGNOSTIC-FACTORS; YOUNG-PATIENTS; OPEN-LABEL; HALF-LIFE; GENDER Multiple languages Hematology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44807