Aggressive chemotherapy in frail patients with diffuse large B-cell lymphoma: The role of pegylated liposomal doxorubicin
Bibliographic record
Abstract
Background : Older patients with cardiac problems and diagnosis of diffuse large B-cell lymphoma generally are treated with reduced-dose chemotherapy and anthracyclines, the best drug in this malignancy, generally is omitted. Thus, survival is very poor in this setting of patients (< 20% at 3 years). Pegylated liposomal doxorubicin (PLD) has been showed clinical activity in younger patients and without excessive cardiac toxicity. Methods: Thus, we began an open label in 69 frail patients (age > 65 years, and with diagnosis of cardiac abnormalities), employed a CHOP-like-regimen, with PLD, 30 mg/m 2 , instead of doxorubicin. Sixty-nine patients were enrolled, in intent to treat analysis all were available for efficacy and toxicity. Results: Complete response was achieved in 52 cases (72%). Three patients were excluded for non-hematological toxicity, and 9 patients relapsed, thus with a median follow-up of 73 months (range 64 to 110 months), actuarial curves at 5-years showed that relapse free survival was 78% (95% confidence interval (CI): 69% to 85%) and overall survival was 79% (95% CI: 71% to 85%). Although severe granulocytopenia was observed in 5.6% of cycles, no death was observed. Two patients die secondary to myocardial ischemia and 10 patients worsened the left ejection ventricular function, but only 3 developed clinical dates of congestive heart failure. Conclusions: We considered that the use of PLD is an effective and safe drug in the treatment of these special setting of patients with the end-point of treatment is cure.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".