[Clinical analysis of rituximab combined with chemotherapy in treating aggressive B-cell non-Hodgkin's lymphoma].
OBJECTIVE
The efficacy of standard treatment, including cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP regimen), for patients with aggressive B-cell non-Hodgkin's lymphoma (B-NHL) is still unsatisfactory. Rituximab, a chimeric monoclonal antibody against B-cell antigen CD20, has therapeutic activity in B-NHL. This study was to determine efficacy and safety of the combination of rituximab and chemotherapy in treating Chinese patients with aggressive B-NHL, and to analyze influence factors on the response.


METHODS
Records of 75 patients with aggressive B-NHL,received infusions of 375 mg/m(2) of rituximab combined with or without chemotherapy in our center,have been retrospectively analyzed. Influence of age, clinical stage, serum level of lactate dehydrogenase (LDH), international prognostic index (IPI) score, and bulk disease on response were evaluated.


RESULTS
Response rate of rituximab alone group was 83.3% (5/6)with complete response (CR) rate of 66.7% (4/6). In 43 naive patients, the combination of rituximab and chemotherapy achieved an overall response rate (ORR) of 90.7% with CR rate of 67.4%; while in 26 recurrent or relapsed patients, the combination therapy achieved an ORR of 79.2% with CR rate of 29.2% (7/26), and partial response (PR) rate of 50.0% (13/26), 6 patients had a progressive disease (20.8%). Efficacy of immunochemotherapy was poor on patients with advanced disease(P=0.046), increased serum level of LDH (P=0.024), recurrence or relapse (P=0.009), and bulk disease (P=0.013). All patients can tolerate the treatment. No treatment-related death occurred.


CONCLUSIONS
The addition of rituximab to the chemotherapy regimen increases the response rate and CR rate in Chinese patients with aggressive B-NHL, without a clinically significant increase in toxicity. Patients with advanced disease, higher serum level of LDH, recurrence or relapse, and bulk disease had a poor response.
Zhang
Hong-Yu
HY
Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, P.R. China.
Lin
Tong-Yu
TY
Jiang
Wen-Qi
WQ
Zhang
Li
L
Huang
Hui-Qiang
HQ
Xia
Zhong-Jun
ZJ
Sun
Xiao-Fei
XF
He
You-Jian
YJ
Guan
Zhong-Zhen
ZZ
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016393:Lymphoma, B-Cell / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D011241:Prednisone