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The impact of CHOP versus bendamustine on bone mineral density in patients with indolent lymphoma enrolled in the GALLIUM study.
- Source :
-
British journal of haematology [Br J Haematol] 2024 Apr; Vol. 204 (4), pp. 1271-1278. Date of Electronic Publication: 2023 Nov 13. - Publication Year :
- 2024
-
Abstract
- Standard CHOP treatment includes a high cumulative dose of prednisone, and studies have shown increased fracture risk following CHOP. It is unclear whether reductions in bone mineral density (BMD) are caused by glucocorticoids or by the combination with chemotherapy. Our objective was to determine the effect of obinutuzumab (G)/rituximab (R)-bendamustine versus G/R-CHOP on BMD in follicular lymphoma patients. Patients in this GALLIUM post hoc study were ≥60 years old and in complete remission at induction treatment completion (ITC), following treatment with G or R in combination with bendamustine or CHOP. To assess BMD, Hounsfield units (HU) were measured in lumbar vertebra L1 on annual computed tomography. Furthermore, vertebral compression fractures were recorded. Of 173 patients included, 59 (34%) received CHOP and 114 (66%) received bendamustine. At baseline, there was no difference in HU between groups. The mean HU decrease from baseline to ITC was 27.8 after CHOP and 17.3 after bendamustine, corresponding to a difference of 10.4 (95% CI: 3.2-17.6). Vertebral fractures were recorded in 5/59 patients receiving CHOP and in 2/114 receiving bendamustine. CHOP was associated with a significant greater decrease in BMD and more frequent fractures. These results suggest that prophylaxis against BMD loss should be considered.<br /> (© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
- Subjects :
- Humans
Middle Aged
Fractures, Compression drug therapy
Prednisone adverse effects
Rituximab adverse effects
Vincristine adverse effects
Antineoplastic Combined Chemotherapy Protocols adverse effects
Bendamustine Hydrochloride adverse effects
Bone Density
Lymphoma, Follicular drug therapy
Spinal Fractures drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2141
- Volume :
- 204
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- British journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 37957542
- Full Text :
- https://doi.org/10.1111/bjh.19194