EVALUATION OF THE ACUTE BIOCHEMICAL CHANGES AND INCIDENCE OF VIRAL AND MYCOBACTERIUM MANIFESTATION ASSOCIATED WITH CHOP WITH OR WITHOUT RITUXIMAB IN DIFFUSE LARGE B-CELL LYMPHOMA PATIENTS
Journal Title: European Journal of Pharmaceutical and Medical Research - Year 2017, Vol 4, Issue 9
Abstract
Background: Diffuse large B-cell Lymphoma is a major hematologic cancer and if left untreated it may lead to death. Cyclophosphamide, hydroxyrubicin, Oncovin Prednisolone and Rituximab- Cyclophosphamide, hydroxyrubic in Oncovin and Prednisolone are gold standard chemotherapy regimen in overall survival of DLBCL patients. The CHOP and R-CHOP produces significant adverse effects and prolong hospital stay. Aims and Objective: This study was conducted to determine the changes in biochemical disturbances and the incidence of varicella zoster virus infection, mycobacterium infection and infusion reaction induced by CHOP and R-CHOP in DLBCL patients. Changes in metabolic profile and incidence of VZV and tuberculosis correlated with dose intensity ratio, the findings of this study will be helpful in choices for the physician to discontinue therapy or delaying treatment. Method: Baseline readings of metabolic profile were taken and treated as control readings of 31 patients. Post-treatment readings of aforesaid parameters were taken after 20 days and treated as post-treatment group. Means readings were compared with common terminology criteria for adverse events v3.0 2006 (CTCAE) to find the differences in biochemical parameters at baseline and 20 days post-treatment. Results: Patients treated with CHOP therapy showed a significant difference of Alkaline Phosphatase ALP (p-value 0.009), direct bilirubin (p-value 0.034) and serum glutamic-pyruvic transaminase (p-value 0.004) was observed before and after the treatment. Whereas patients treated with RCHOP had only 3 (19%) infusion reaction as per the Common Terminology Criteria for Adverse Events (CTCAE) 2006. Whereas 2 (12%) of patients had herpes simplex viral infection after the RCHOP chemotherapy. Patients treated with CHOP 1 (6.6%) had HSV manifestation. Bacterial Pneumonia was only 1 (5%) reported after RCHOP cycle. Only 1 (5%) had CMV manifestation after the rituximab containing therapy. Conclusion: In summary, subjects at baseline metabolic impairments should be corrected rigorously at the start of chemotherapy of CHOP or R-CHOP cycles that may leads to life threatening renal and hepatic toxicities. R-CHOP is well tolerated than CHOP in term of toxicities.
Authors and Affiliations
Dr. Kashif Ali
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