A preventative treatment consisting of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) treatment without prednisone combined with antacids and anti-Helicobacter pylori therapy can decrease the risk of hemorrhage and perforation in patients with localized primary gastric diffuse large B-cell lymphoma (DLBCL) during immunochemotherapy, according to a new study published in the journal Cancer Medicine.
This kind of treatment can also lead to better event-free and overall survival. However, these advantages are only seen in patients in the early stages of the disease. Patients with localized primary DLBCL commonly experience stomach hemorrhage and perforation while being treated with immunochemotherapy.
Read more about the diagnosis of DLBCL
To explore a potential way to prevent these very serious complications, a team of researchers from China conducted a retrospective study on 198 patients diagnosed with localized primary DLBCL.
Of these 198 patients, 146 patients received standard R-CHOP treatment, which consists of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone while 52 received preventative treatment, which consisted of R-CHOP without prednisone combined with antacids and anti-Helicobacter pylori therapy until the complete recovery of gastric ulcers at which point prednisone was started.
The results showed that none of the patients with stages 1 and 2 of the disease who received preventative treatment had hemorrhage and perforation, while 12.8% of those who received the standard R-CHOP treatment did.
The rate of 5-year event-free survival of patients who received preventative treatment was 97.1%, while that of patients who received standard R-CHOP treatment was only 66.1%. Similarly, the 5-year overall survival rate of patients who received preventative treatment was higher at 100% compared to 72% for those who received standard R-CHOP.
However, the researchers found no differences in terms of 5-year event-free or overall survival between the 2 treatment groups in patients whose disease was disseminated.
Zhang L, Huang H, Wang Z, et al. A study on the prevention of hemorrhage and perforation in patients with primary gastric diffuse large-B cell lymphoma during treatment with immunochemotherapy. Cancer Med. Published online January 9, 2023. doi:10.1002/cam4.5486