Rituximab-CHOP Versus CHOP Alone in Patients with Diffuse Large B Cell Lymphoma.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4708-4708
Author(s):  
Mustafa Cetiner ◽  
Taflan Salepci ◽  
Elif Birtas Atesoglu ◽  
Mahmut Gumus ◽  
Aslihan Guven ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Newly Diagnosed ◽  
Chop Chemotherapy ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell ◽  
Chop Therapy

Abstract Recently, the cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen plus rituximab (R-CHOP) have been used widely to treat patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) and it has also been reported to improve the outcome of DLBCL. We represent a retrospective analysis of newly diagnosed DLBCL patients between the years of 2003–2005 to evaluate the impact of R-CHOP therapy on response rates. Patients with DLBCL between 20–80 years of age (median: 46.0 and mean 56.2 ± 14.92) received 6 cycles of R-CHOP (n=28). For comparison, DLBCL patients between 15–76 years of age (median: 60.5 and mean 47.3 ± 16.6) who received 6 courses of CHOP therapy (n=30) were used as the control group. All patients received classical CHOP (cyclophosphamide 750 mg/m m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m m2 on day 1 and prednisone 40 mg/m m2 for 5 days) every 4 weeks. In R-CHOP group, rituximab 375 mg/m m2 was administered one day before CHOP chemotherapy. The median follow-up for R-CHOP and CHOP groups were 15.66 ± 5.90 (7–29) and 21.79 ± 9.20 (8–46) months, respectively. The International Prognostic Index (IPI) scores were not significantly different between these groups (median IPI of R-CHOP: 2.0 and mean IPI 2.01.27 ± 1.16 versus median IPI of CHOP: 1.0 and mean IPI 1.88 ± 1.26). Complete response (CR) and complete undetermined response (CuR) rate for R-CHOP was 92% (26 of 28 patients) which was statistically significantly higher than CHOP (24 of 30 patients, 80%) (p=0.004). Partial response (PR) rates for R-CHOP and CHOP groups were 7% (2 of 28 patients) and 10% (3 of 30 patients), respectively. While there were no unresponsive patients in the R-CHOP group, refractory disease rate was 10% (3 of 30 patients) in the CHOP group. Relapse rates during the follow up period were 13% (4 of 30 patients) for CHOP and 4% (1 of 28 patients) for R-CHOP group (p<.0001). No long-term toxicity appeared to be associated with the addition of rituximab to the CHOP combination. These results also confirmed the benefit of the addition of rituximab to standard CHOP chemotherapy in DLBCL even in young patients with low IPI scores.

FcγRIIIa Gene Polymorphisms May Correlate with Response to Frontline R-CHOP Therapy for Diffuse Large B-Cell Lymphoma.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2457-2457
Author(s):  
Dong Hwan Kim ◽  
Hee Du Jung ◽  
Sang Kyun Sohn ◽  
Je-Jung Lee ◽  
Deok-Hwan Yang ◽  
...  
Keyword(s):  
B Cell ◽  
Gene Polymorphisms ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Effector Cells ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell ◽  
Chop Therapy

Abstract Background: The precise mechanism of rituximab (R) plus CHOP (R-CHOP) therapy in diffuse large B-cell lymphoma (DLBCL) is not fully elucidated. Besides overcoming bcl-2 mediated chemoresistance, antibody-dependent cellular cytotoxicity (ADCC), which is activated by effector cells via IgG fragment C receptors (FcR), was also proposed as a mechanism of Rituximab. The current study evaluated the impact of FcR polymorphism on the response to R-CHOP therapy for DLBCL with the basis that FcR polymorphism can affect R’s affinity for ADCC effector cells. Patients and Methods: The FcγRIIIa and FcγRIIa gene polymorphisms were determined in DLBCL patients receiving R-CHOP (n=113) comparing to CHOP therapy (n=85). Results: The FcγRIIIa valine (V) allele was significantly correlated with higher complete response rate to R-CHOP compared to phenylalalnine (F) allele (88% in V/V versus 79% in V/F versus 50% in F/F, p=0.002), while no difference was found between FcγRIIa polymorphism. In addition, V/V allele was associated with faster achievement of response than other alleles. The impact of FcγRIIIa gene polymorphism on response rate was not noted in CHOP group. In terms of overall or event-free survival, no difference was found according to FcγRIIIa or FcγRIIa alleles. Conclusion: The FcγRIIIa SNP is predictive of response to R-CHOP, but does not correlate with survival in DLBCL patients.

The Impact of Relative Dose Intensity (RDI) of CHOP on Outcome of Diffuse Large B-Cell Lymphoma: Results of a Single Center Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4456-4456
Author(s):  
Yoshiki Terada ◽  
Hirohisa Nakamae ◽  
Takahiko Nakane ◽  
Hideo Koh ◽  
Yasunobu Takeoka ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Outcomes ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Abstract Introduction: The achievement of a clinical response to the first induction chemotherapy has been considered for predicting survival in patients (pts) with aggressive non-Hodgkin lymphoma (NHL). Reduced dose intensity of chemotherapy has been likely to compromise long-term outcome of the patients with aggressive NHL treated with a standard chemotherapy of cyclophosphamide (CY), doxorubicin (ADR), vincristine and prednisone (CHOP). In particular, recent studies have revealed the relevance of relative dose intensity (RDI) to clinical outcomes, with reduced RDI leading to a poor survival, as well as the impact of RDI<85% for aggressive NHL with detailed analysis of risk factors influencing reduce RDI<85% (Gary H. Lyman, J. Clin Oncol22: 4302, 2004). This study was conducted to investigate the impact of RDI<85% of CHOP on outcomes of the pts with diffuse large B-Cell lymphoma (DLCL). Methods: Data were retrospectively collected on 100 pts with DLCL who had been initially treated with more than 3 courses of CHOP (n=70) or CHOP plus rituximab (CHOP-R, n=30) at our institution between 1995 and 2006. We evaluated whether RDI might affect clinical outcomes, including complete response (CR) and event free survival (EFS). The average RDI derived from CY and ADR (referred to as RDI-CY/ADR) was determined for each patient, with classified into 2 populations according to the differences from the value of 85%, including RDI-CY/ADR<85% (n=60), and RDI-CY/ADR≥85% (n=40). Results: The median age of the study population was 54 years (range, 17 to 76), with 36 pts older than 60 years (yrs) of age. According to International Prognostic Index (IPI) score, pts were classified into 2 groups of low/ low-intermediate (n=46) and high/ high-intermediate (n=54). The overall CR rate reached 62%, and the probability of overall survival (OS) or EFS at 5 years estimated 77% or 43%, respectively with a median follow-up of 13.3 months. Multivariate analysis identified RDI-CY/ADR<85%, as well as IPI score to be associated with CR rate and EFS. Thus, RDI-CY/ADR<85% and IPI score of high/ high-intermediate were significant factors for lower CR rate (as RDI-CY/ADR≥85%, HR=0.3, 95% CI 0.1 to 0.7, p=0.009, and HR=5.5, 95% CI 2.2 to 14, p<0.001, respectively), and for reduced EFS (HR=1.9, 95% CI 1.0 to 3.7, p=0.048, and as IPI score of low/ low-intermediate HR=0.3, 95% CI 0.2 to 0.6, p<0.001, respectively). Furthermore, logrank analysis revealed that CY/ADR-RDI<85% was the significant factor for reduced EFS in non elderly pts (≤60 yrs of age), or in pts with IPI score of low/ low-intermediate (p=0.01, p=0.02, respectively). Conclusion: These data thus suggested the impact of RDI-CY/ADR<85% in influencing outcomes of the pts with DLCL, in terms of CR rate and EFS. Further investigation is currently planned to confirm this promising results with longer follow-up in larger numbers of pts with NHL.

Rituximab Does Not Improve Progression Free (PFS) or Overall Survival (OS) in Patients with Limited Stage Diffuse Large B Cell Lymphoma (DLBCL).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3755-3755
Author(s):  
Ephraim P. Hochberg ◽  
Nicole Birrer ◽  
Christiana E. Toomey ◽  
Jeffrey A. Barnes ◽  
Alfred Ian Lee ◽  
...  
Keyword(s):  
Overall Survival ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Newly Diagnosed ◽  
Logrank Test ◽  
Limited Stage ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Abstract Abstract 3755 Poster Board III-691 Introduction Diffuse Large B Cell Lymphoma (DLBCL) is the most common lymphoid malignancy accounting for approximately 33% of all newly diagnosed NHLs. Three randomized trials and multiple retrospective analyses have demonstrated both progression-free (PFS) and overall survival (OS) benefit to the addition of the anti-CD20 monoclonal antibody rituximab to anthracycline-containing chemotherapy in older advanced-stage patients, and in young low-risk patients with DLBCL. Approximately half of newly diagnosed patients with DLBCL present in limited stage and the benefit of rituximab containing chemotherapy regimens for these patients remains uncertain. Methods We used an IRB-approved clinicopathologic database, derived from comprehensive tumor registry data at the Massachusetts General Hospital, Dana Farber Cancer Institute and Brigham and Women's Hospital, to identify all patients 18 years or older diagnosed with limited stage DLBCL between 2000 and 2006. We included all patients treated with 3 or more cycles of anthracycline containing chemotherapy with curative intent. We excluded primary DLBCL of the CNS. We determined the impact of the use of rituximab on OS and PFS. PFS and OS were calculated from the date of initial diagnosis. Results A total of 138 patients met eligibility criteria and are included in the analysis. Median age was 51 years (range 18-89 years). 30% of patients were above 60 years of age, and less than 3% had an IPI score of 3 or higher. One hundred and six patients received CHOP + rituximab (RCHOP) and 32 received CHOP alone. Of the 106 patients receiving RCHOP, 48 were irradiated and 58 were not. Of the 32 patients receiving CHOP, 20 received radiation and 12 did not. At a median follow-up of 35 months (range 3-109 months), PFS and OS for the entire cohort are 86.2% and 90.6%, respectively. On univariate analysis of outcome, the addition of rituximab to CHOP did not improve PFS (81.3% vs. 87.7%,p=0.817, Logrank Test) or OS (84.4% vs. 92.5%, p=0.411, Logrank Test). Conclusion The outcome of an unselected series of patients with limited stage DLBCL is excellent. In this retrospective cohort of patients with limited stage DLBCL, the use of rituximab in conjunction with standard chemotherapy did not improve PFS or OS. The results we obtained are very similar to those reported by SWOG (Persky et al. JCO 2008). The overlapping confidence intervals for PFS and OS between SWOG 0014 and 8736 patients and our data suggest that a large multicenter trial will be needed to show a benefit of rituxan in this extremely good prognosis population. Disclosures: Hochberg: Genentech: Speakers Bureau; Biogen-Idec: Speakers Bureau; Enzon: Speakers Bureau; Amgen: Speakers Bureau.

Lymphocyte Count Persistence and Early Recovery Predicts Superior Survival and Is Independent of the International Prognostic Index in Patients Treated with CHOP Chemotherapy for Diffuse Large B Cell Lymphoma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3252-3252 ◽  
Author(s):  
Luis F. Porrata ◽  
Kay M. Ristow ◽  
Svetomir N. Markovic ◽  
Daniel Persky ◽  
Thomas M. Habermann
Keyword(s):  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Newly Diagnosed ◽  
Chop Chemotherapy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract The peripheral blood absolute lymphocyte count (ALC) post-autologous stem cell transplantation is an independent predictor for survival in non-Hodgkin’s lymphoma. The role of ALC recovery during and after standard CHOP chemotherapy for newly diagnosed diffuse large B cell lymphoma (DLBCL) has not been reported. We hypothesized that ALC recovery during/after CHOP chemotherapy has a direct impact on survival. 135 consecutive newly diagnosed patients with DLBCL treated with CHOP from 1994 through 2000 were retrospectively analyzed. The primary end point was to assess the role of ALC recovery during and after CHOP on progression-free survival (PFS) and overall survival (OS). The ALC recovery before each of the 6 cycles and at 3 months follow-up after completion of therapy were analyzed. Of the 135 patients, 41 patients received concomitant radiation therapy. The median age was 64 years (range: 21–83) and median follow-up was 46 months (range: 1–124). Superior OS and PFS were identified in patients achieving the ALC cut-off value that discriminated clinical outcomes at a high level of significance for blood counts obtained before cycles 1 (ALC ≥ 1.5 x 109/L, OS = not reached vs 54 months, p< 0.0048; PFS = not reached vs 23 months, p <0.0005), 2 (ALC ≥1.5 x 109/L, OS = not reached vs 59 months, p <0.0255; PFS = not reached vs 30 months, p <0.0082), 3(ALC ≥1.2 x 109/L, OS = not reached vs 59 months, p<0.0074; not reached vs 30 months, p <0.0060), and at 3 months (ALC ≥ 1.2 x 109/L, OS = not reached vs 60 months, p< 0.0080; PFS = not reached vs 42 months, p < 0.0017). Similar cut-off points for cycles 4 through 6 could not be identified. The ALC recovery between each cycles 1–3 and at 3 months were not independent of each other. Multivariate analysis demonstrated ALC for cycles 1–3 and at 3 months post CHOP to be independent prognostic factor for OS and PFS when compared to other significant prognostic factors including International Prognostic Index and radiation therapy. Patients were stratified into three groups based on whether or not they achieved cut-off values of ALC in the first 3 cycles: group I= ALC achieved in at least 2 of 3 cycles; group II= ALC achieved in only 1/3 cycles; and group III= ALC cut-off not achieved. A trend towards worse OS (p< 0.0035) (Figure 1) and PFS (p< 0.0003) was identified if patients did not achieve any of the cut-off values of ALC in the first 3 cycles. These data further support the hypothesis that there is a critical role of lymphocyte (immune) recovery during and after CHOP chemotherapy in DLBCL.

Biweekly CHOP therapy improves therapeutic effect in the non-GCB subtype of diffuse large B-cell lymphoma

Open Medicine ◽  
2007 ◽  
Vol 2 (4) ◽  
pp. 488-498 ◽  
Author(s):  
Qingyuan Zhang ◽  
Jingxuan Wang ◽  
Jincai Wang
Keyword(s):  
B Cell ◽  
Standard Treatment ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Chop Regimen ◽  
Large B Cell Lymphoma ◽  
Germinal Center B Cell ◽  
Large B Cell ◽  
Chop Therapy

AbstractCHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) is accepted as the best available standard treatment for diffuse large B-cell lymphoma (DLBCL) patients; however, the therapeutic efficacy seems unsatisfactory. Additional rituximab will improve the cure rate, but it is not popular in China because of its increased medical cost. Germinal center B-cell (GCB) and non-GCB subtypes distinction have been described as independent prognostic factors, and provides likelihood for cure with chemotherapy. The aim of the study is to explore the association between Immunophenotype and treatment regimen. Between August 2003 and May 2006, 66 patients with DLBCL were enrolled, according to immunohistochemistry results (GCB and non-GCB phenotype), randomly assigned to receive either six to eight cycles of CHOP every 2 weeks or standard CHOP every 3 weeks. After a median follow-up duration of 32 months (range of 4 to 42 months), an estimated 3-year overall survival (OS) rate for the GCB patients were 68.2% and 55.6% for the biweekly CHOP regimen and standard CHOP regimen respectively, while the data were 62.8% and 37.9% respectively for the non-GCB cases. The biweekly CHOP therapy showed higher efficacy than standard treatment, and its superiority was more obvious with the non-GCB subgroup. All rights reserved.

scholarly journals Chidamide Plus R-CHOP21 in Elderly Patients with Newly Diagnosed Diffuse Large B-Cell Lymphoma: Results of a Phase II Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2968-2968 ◽  
Author(s):  
Muchen Zhang ◽  
Ying Fang ◽  
Pengpeng Xu ◽  
Shu Cheng ◽  
Li Wang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
B Cell ◽  
Phase Ii Study ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Newly Diagnosed ◽  
Large B Cell Lymphoma ◽  
Grade 3 ◽  
Large B Cell

Abstract Background: Diffuse large B-cell lymphoma (DLBCL) represents the most common subtype of non-Hodgkin's lymphoma and is heterogeneous in clinical, immunophenotypic and genetic features. More than 50% of patients with DLBCL are older than 60 years at diagnosis. Among them, up to 40% of patients relapse or develop refractory disease upon R-CHOP treatment. Dose-dense R-CHOP14 failed to show superior efficacy or survival compared with standard R-CHOP21 in elderly patients and intensive chemotherapy followed by autologous stem cell transplantation was difficult due to toxicity. Therefore, development of new first-line therapy remains great interests to improve disease outcome in elderly patients with DLBCL. Perturbation of the epigenome plays a crucial role in lymphoma progression. Several histone deacetylase inhibitors (HDACIs) have been investigated in relapsed or refractory DLBCL as mono- or combination treatment, showing promising activities to suppress lymphoma growth and overcome resistance to immune-chemotherapies. This prospective phase II study was to evaluate the efficacy and safety of chidamide in combination with R-CHOP21 in elderly patients with newly diagnosed DLBCL (NCT02753647). Methods: Patients with newly diagnosed DLBCL, aged 61 to 75 years, Eastern Cooperative Oncology Group performance status of 0 to 2, IPI>1 were enrolled. The dose and administration schedule were as follows: rituximab 375 mg/m2 on day 0, cyclophosphamide 750mg/m2 on day 1, doxorubicin 50mg/m2 on day 1, vincristine 1.4 mg/m2 on day 1, prednisone 60 mg/m2 from day 1 to day 5, chidamide 20mg/d on days 1, 4, 8 and 11, every 21 days for 6 cycles. The primary endpoint was complete response (CR) rate assessed by PET-CT, and secondary endpoints included progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and main adverse events (AEs). Results: From March 2016 to April 2018, 49 patients were enrolled; 41 patients completed all treatment and 8 patients were still in the treatment cycles. Median age was 67 years (range, 61-75) and 28 patients (57.1%) were male. Thirty-eight patients (77.6%) presented advanced Ann Arbor stage, and 41 patients (83.7%) showed elevated serum LDH level. Thirty-one patients (63.3%) had multiple extra-nodal sites, mainly involving bone, gastrointestinal, liver, and bone marrow. Forty-one patients (83.7%) had IPI scores ≥3 at diagnosis. By immunohistochemistry, 12 (24.5%) patients were categorized as germinal center B-cell (GCB) subtype based on Hans algorithm, and 12 (25.5%) patients were defined as BCL-2 and MYC double expression. Among 41 patients available for evaluation, the CR rate was 85.4% (35/41), and the ORR was 90.3% (37/41). After a median follow-up of 18 months (range, 3-30), the 1-year PFS was 92.1% and 1-year OS was 94.7%. There were 2 deaths due to disease progression, of which 1 had triple-hit lymphoma. Regarding toxicity, grade 3-4 neutropenia was observed in 167 cycles (60.5%), grade 3-4 thrombocytopenia in 27 cycles (9.8%), and grade 3 anemia in 11 cycles (4.0%). However, febrile neutropenia was reported in significantly fewer cycles (6.1%) and was a maximum of grade 3. Grade 3 liver dysfunction was observed in 7 cycles (2.5%). No grade 4 non-hematological events were reported. Of note, 2 patients positive for EBER-ISH at diagnosis remained in EBV-DNA negative during treatment and follow-up. Conclusion: Chidamide with R-CHOP21 is effective and safe in elderly patients with newly diagnosed DLBCL. Disclosures No relevant conflicts of interest to declare.

scholarly journals Surveillance Imaging in Patients with Diffuse Large B-Cell Lymphoma

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4883-4883
Author(s):  
Ayako Matsumura ◽  
Hideyuki Kuwabara ◽  
Kumiko Kishimoto ◽  
Eriko Fujii ◽  
Kazuho Miyashita ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Symptoms ◽  
Cell Lymphoma ◽  
Clinical Stage ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Surveillance Imaging ◽  
Large B Cell ◽  
Chop Therapy

Abstract Background: Approximately 80% of patients with diffuse large B-cell lymphoma (DLBCL) achieve a complete response (CR) after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy (R-CHOP) as first-line treatment but approximately 25% of patients with CR experience relapse. Disease recurrence generally occurs in the first 2 years following the first CR, but some patients relapse in the 5 years following the first CR. The optimal follow-up strategy for patients with non-Hodgkin's lymphoma has been under consideration. There are limitations to surveillance imaging, including risk of increase in healthcare costs, and increased anxiety due to the possibility of recurrence. To assess the role of surveillance imaging in the rituximab era, we retrospectively analyzed DLBCL patients, treated with a uniform treatment regimen, who relapsed after achieving the first CR. Patients and Methods : Between 2004 and 2009, DLBCL patients were newly diagnosed and were treated with 6 to 8 cycles of full-dose R-CHOP therapy (50 mg/m2 doxorubicin, 750 mg/m2 cyclophosphamide and 1.4 mg/m2 [maximum 2.0 mg/body] vincristine on day 1, 100 mg/body per day of prednisolone on days 1 to 5, and 375 mg/m2 rituximab per treatment cycle; treatment cycles were repeated every 3 weeks) at the 8 institutions of the Yokohama City University Hematology Group. Physical examinations were performed every 1 to 3 months, and periodical CT was generally performed every 6 months for 5 years after achieving CR. The relapses were categorized into 2 groups based on the modality of detection. One group consisted of the relapses that were detected by surveillance imaging (SI) in the absence of symptoms. The other group was composed of relapses that were detected by clinical symptoms, abnormal laboratory data, or SI in the presence of symptoms. Overall survival (OS) was measured from the start of the initial treatment until the time of the last follow-up or death. Using Kaplan-Meier survival analysis and the log-rank test, we assessed OS based on the modality of relapse detection. Result s: In total, 315 patients with DLBCL were diagnosed and treated with R-CHOP therapy. Further, 289 patients achieved the first CR. We identified 52 patients who relapsed after the first CR. The patients who relapsed were at a more progressed clinical stage and had a higher International Prognostic Index (IPI) score than the patients in CR, although there were no significant differences in the age, gender, or median duration of follow-up between the patients with or without CR. Of the 52 relapsed patients, 19 relapses (37%) were detected by routine SI in the absence of clinical symptoms. The remaining 33 relapses (63%) were detected by SI in the presence of clinical symptoms (CS) or were detected following unscheduled imaging due to the presence of clinical symptoms or abnormal laboratory findings. The most frequently observed clinical symptom in the CS group was lymphadenopathy (n = 13, 39%). Median observation period after the first relapse in the 24 survivors (10 in SI group and 14 in CS group) was 62 months. There were no significant differences in age, gender, clinical stage, IPI, or median relapse-free duration between the SI and CS groups. The OS curve is shown in Figure below. There was no significant difference (P = 0.23) in the 5-year OS rates in the SI and the CS groups. Conclusion: Periodic surveillance imaging does not prolong the OS in relapsed patients. There are more to be discussed about the follow up strategy for DLBCL. Disclosures No relevant conflicts of interest to declare.

Rituximab Plus Dose Enhancement and Biweekly Administration of CHOP for Newly-Diagnosed Patients with Diffuse Large-B-Cell Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4726-4726
Author(s):  
Francisco Javier ◽  
E. Ríos ◽  
M. Almagro ◽  
J.M. Durán-Cabral ◽  
J.N. Rodríguez ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Standard Dose ◽  
B Cell Lymphoma ◽  
Newly Diagnosed ◽  
Efficacy And Safety ◽  
Dose Intensification ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Introduction: Rituximab plus CHOP every 3 weeks is associated with a increase in the survival of elderly patients. Dose intensification and dose compression with G-CSF support may provide an advantage compared with standard-dose CHOP. Purpose: To evaluate the efficacy and safety of Rituximab plus CHOP with increased dose of cyclophosphamide and shortened intervals between chemotherapy courses in newly-diagnosed patients with diffuse large-B-cell lymphoma. Therapeutic scheme: Rituximab 375 mg/m2 (d1), cyclophosphamide 1.500 mg/m2 (d1), vincristine 1.4 mg/m2 maximum 2 mg (d1), adriamycin 50 mg/m2 (d1) and prednisone were given. G-CSF (5–10 μg/kg) was added on days 3 to 11 in each course. Six to 8 courses were applied at 14-day intervals. Results: Between january 2002 and may 2005 twenty eight patients, from seven institutions, were included in this study and received 187 courses. Their median age was 48 years (19 to 59 years). The four last patients have not yet finished their treatment and were not evaluable for response. All patients exhibited alopecia and acceptable myelosupression. Thirteen episodes of fever were reported. Among 24 evaluable patients ORR was 83.3% (70.8% CR and 12.5% PR). With a median follow-up of 11 months (range 4–42) the OS and EFS at 30 months is 83% and 75%, respectively. Conclusions: The administration of Rituximab plus CHOP every 14 days with enhanced dose of cyclophosphamide is safe. The toxicity is mainly hematological, but can be surmounted with the use of G-CSF and EPO. Recruitment of more patients and longer follow-up are required to confirm these results.

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