ALBERT

Description: During the recent years CHOP-14 based chemotherapy in combination with the monoclonal anti-CD20 antibody Rituximab has become the standard choice of treatment for non-localized, poor risk Diffuse Large B-Cell Lymphoma (DLBCL). The German NHL-B1 and -B2 trials have demonstrated favourable efficacy and safety. We, and others, have observed a relatively high frequency of severe toxicity, infections and malnutrition in very high-risk patients, responsible for increased morbidity during treatment. To our knowledge, no studies have evaluated QoL in patients treated with CHOP-14 based chemotherapy. The aim of this study was to prospectively evaluate whether QoL was affected in DLBCL patients treated with dose-dense CHOP-based chemotherapy. Health-related QoL was assessed using the validated EORTC QLQ-C30 (version 3) questionaire, which is a 30-item instrument developed specifically for use in international clinical cancer research. 26 patients with DLBCL (22 (85%) de novo and 4 (15%) transformed follicular lymphoma) were included. Median age was 59 years (27–78), 18 (69%) had CS III/IV disease, 14 (54%) extranodal involvement, 19 (73%) elevated LDH, 10 (39%) a Performance Score ≥2, i.e. 13 (50%) presented with IPI 3–5 disease. Furthermore, 7 (27%) had bone marrow involvement, 13 (50%) bulky disease and 18 (69%) B-symptoms. All patients received 6 or 8 cycles of CHOP-14 based chemotherapy, and 17 of the patients received Rituximab at day 1 of each cycle. The patients completed the QLQ-C30 questionaire at four predefined timepoints according to chemotherapy treatment: pre-treatment, mid-treatment (14 days after the 4th cycle), 14 days post-treatment and 3 months post-treatment. Patient scores were compared to scores from an age- and gender-adjusted reference population, and separately analyzed over time (using non-parametric statistical analyzes). At pre-treatment only global health status (p=0.008) and role functioning (p=0.049) were impaired compared to the reference population. During treatment, global health status (p=0.008), physical functioning (p