title: Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte.
abstract: OBJECTIVE
  To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma.
  
  
  METHODS
  LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), vincristine 1.4 mg/m(2), and prednisone 40 mg/m(2) for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m(2) was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle.
  
  
  RESULTS
  Median follow-up is 5 years at present. Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the R-CHOP combination.
  
  
  CONCLUSIONS
  Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.
authors.affiliation: Hematology Department, Centre Hospitalier Universitaire de Brabois, 54500 Vandoeuvre les Nancy, France. p.feugier@chu-nancy.fr
authors.forename: P
authors.initials: P
authors.lastname: Feugier
authors.forename: A
authors.initials: A
authors.lastname: Van Hoof
authors.forename: C
authors.initials: C
authors.lastname: Sebban
authors.forename: P
authors.initials: P
authors.lastname: Solal-Celigny
authors.forename: R
authors.initials: R
authors.lastname: Bouabdallah
authors.forename: C
authors.initials: C
authors.lastname: Fermé
authors.forename: B
authors.initials: B
authors.lastname: Christian
authors.forename: E
authors.initials: E
authors.lastname: Lepage
authors.forename: H
authors.initials: H
authors.lastname: Tilly
authors.forename: F
authors.initials: F
authors.lastname: Morschhauser
authors.forename: P
authors.initials: P
authors.lastname: Gaulard
authors.forename: G
authors.initials: G
authors.lastname: Salles
authors.forename: A
authors.initials: A
authors.lastname: Bosly
authors.forename: C
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: F
authors.initials: F
authors.lastname: Reyes
authors.forename: B
authors.initials: B
authors.lastname: Coiffier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018450:Disease Progression; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D000069283:Rituximab; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone