Timing chemotherapy improves treatment results for female lymphoma patients: Study

In "chronochemotherapy" the aim is timing the delivery of the drug when the body is least vulnerable to the harmful effects of the drug, while the cancer cells are at their most vulnerable.

A group of South Korean researchers studied a group of patients suffering from Diffuse large B-cell lymphoma (DLBCL).They analyzed 210 patients to investigate whether there is any difference between morning and afternoon treatment.

It was found that female patients who received afternoon treatment had 12.5 times reduced mortality rate , while the cancer recurrence after 60 months was decreased by 2.8 times. In addition, chemotherapy side effects such as neutropenia were more common in female patients who received morning treatment. Surprisingly, there was no difference in treatment efficiency depending on the treatment schedule in the case of male patients.

To understand the cause of gender differences, the research team analyzed ~14,000 blood samples from the Seoul National University Hospital Health Examination Center. It was found that in females, white blood cell count tends to decrease in the morning and increase in the afternoon. This indicates that the bone marrow proliferation rate is higher in the morning than in the afternoon because there is a ~12hr delay between the bone marrow proliferation and blood cell production.

This means that if a female patient receives chemotherapy in the morning when bone marrow is actively producing blood cells, the possibility of adverse side effects becomes greater. Unlike female patients, it was found that male patients did not show a significant difference in white blood cell count and bone marrow cell proliferation activity throughout the day, which is the reason why the timing of the treatment had no impact.

Reference:

Professor KOH Young-il et al,Chemotherpay delivery time affects treatment outcomes of female patients with diffuse large B-cell lymphoma,JCI Insight,doi 10.1172/jci.insight.164767