ArticleJCI insight2023
Chemotherapy delivery time affects treatment outcomes of female patients with diffuse large B cell lymphoma.
Article in JCI insight, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 34 citations in OpenAlex.
- Biological Rhythms in Coronavirus Pneumonia Pathogenesis.Journal of biological rhythms · 2026Article
- Chronotherapy in Hematological Malignancies: Evaluating the Rationale and Evidence.Pharmacology research & perspectives · 2026Review
- Chronotherapeutic administration of neoadjuvant chemotherapy reduces cancer-related fatigue-like behavior.Brain, behavior, & immunity - health · 2026Article
- Review
- Design considerations for hypertension chronotherapy trials: insights from experience and modelling.BMC medicine · 2026Review
- Article
- The importance of the season of biopsy on the Gleason score on biopsy: does exposure to sunshine have an influence?Asian journal of andrology · 2026Article
- Optimizing oral contraceptive timing: Daytime intake reduces doses and enhances efficacy.PLoS computational biology · 2026Article
- Chronotherapy as a novel strategy to limit anthracycline-induced cardiotoxicity.Cardiovascular research · 2025Review
- Employing nullclines to balance treatment efficacy and neurotoxicity for sustained tumor control.Mathematical biosciences · 2025Article
- Morning administration of anthracyclines is associated with a lower risk of cancer therapy-related cardiac dysfunction.European heart journal open · 2025Article
- Cardiogenic and chronobiological mechanisms in seizure-induced sinus arrhythmias.PLoS computational biology · 2025Article
- Combining lineage correlations and a small molecule inhibitor to detect circadian control of the cell cycle.iScience · 2025Article
- Review
- Chrono-tailored drug delivery systems: recent advances and future directions.Drug delivery and translational research · 2024Review
- Brief Report: Clinical Outcomes by Infusion Timing of Immune Checkpoint Inhibitors in Patients With Locally Advanced NSCLC.JTO clinical and research reports · 2024Article
- Temporal Considerations in Brain Metastases Radiation Therapy: The Intersection of Chronobiology and Patient Profiles.Clocks & sleep · 2024Article
- Molecular mechanisms of tumour development in glioblastoma: an emerging role for the circadian clock.NPJ precision oncology · 2024Review
- Circadian immunity from bench to bedside: a practical guide.The Journal of clinical investigation · 2024Review
- Circadian regulation of sinoatrial nodal cell pacemaking function: Dissecting the roles of autonomic control, body temperature, and local circadian rhythmicity.PLoS computational biology · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUNDChronotherapy is a drug intervention at specific times of the day to optimize efficacy and minimize adverse effects. Its value in hematologic malignancy remains to be explored, in particular in adult patients.METHODSWe performed chronotherapeutic analysis using 2 cohorts of patients with diffuse large B cell lymphoma (DLBCL) undergoing chemotherapy with a dichotomized schedule (morning or afternoon). The effect of a morning or afternoon schedule of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) on survival and drug tolerability was evaluated in a survival cohort (n = 210) and an adverse event cohort (n = 129), respectively. Analysis of about 14,000 healthy individuals followed to identify the circadian variation in hematologic parameters.RESULTSBoth progression-free survival (PFS) and overall survival (OS) of female, but not male, patients were significantly shorter when patients received chemotherapy mostly in the morning (PFS HR 0.357, P = 0.033; and OS HR 0.141, P = 0.032). The dose intensity was reduced in female patients treated in the morning (cyclophosphamide 10%, P = 0.002; doxorubicin 8%, P = 0.002; and rituximab 7%, P = 0.003). This was mainly attributable to infection and neutropenic fever: female patients treated in the morning had a higher incidence of infections (16.7% vs. 2.4%) and febrile neutropenia (20.8% vs. 9.8%) as compared with those treated in the afternoon. The sex-specific chronotherapeutic effects can be explained by the larger daily fluctuation of circulating leukocytes and neutrophils in female than in male patients.CONCLUSIONIn female DLBCL patients, R-CHOP treatment in the afternoon can reduce toxicity while it improves efficacy and survival outcome.FUNDINGNational Research Foundation of Korea (NRF) grant funded by the Korean government (grant number NRF-2021R1A4A2001553), Institute for Basic Science IBS-R029-C3, and Human Frontiers Science Program Organization Grant RGY0063/2017.
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