title: A phase II trial of rituximab as adjuvant to intensive sequential chemotherapy in patients under 60 years with untreated poor-prognosis diffuse large B-cell lymphoma.
abstract: The potential benefit of rituximab as adjuvant to high-dose therapy (HDT) has been investigated in patients under 60 years with poor-risk (age-adjusted international prognostic index at 2-3) CD20+ diffuse large B-cell lymphoma (DLBCL). The treatment consisted of four cycles of high-dose CEOP (cyclophosphamide, epirubicin, vincristine, prednisone), plus etoposide and cisplatin during the two last cycles. Peripheral blood stem cells were collected after cycle 1, and reinfused after cycles 3 and 4. Four weekly rituximab infusions were subsequently delivered. Among the 36 patients included, 30 could complete chemotherapy schedule, and 24/36 received rituximab. A complete response occured in 26/36 patients (72%). With a median follow-up of 30 months, the estimated 5-year overall survival (OS) and event-free survival (EFS) rates (mean +/- s.d.) were 65 +/- 16 and 63 +/- 15%, respectively. For the 24 patients who received both chemotherapy and rituximab, the estimated 5-year OS and EFS rates were 86 +/- 14 and 82 +/- 15%. These data suggest that rituximab after HDT is feasible. Both complete remission rate and survival curves compare favorably with the poor outcome usually observed in high-risk DLBCL patients managed with HDT without rituximab.
authors.affiliation: Department of Hematology, Cancer Center Institut J Paoli - I Calmettes, Marseille Cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Coso
authors.forename: C
authors.initials: C
authors.lastname: Sebban
authors.forename: O
authors.initials: O
authors.lastname: Boulat
authors.forename: P
authors.initials: P
authors.lastname: Biron
authors.forename: J
authors.initials: J
authors.lastname: Rey
authors.forename: T
authors.initials: T
authors.lastname: Aurran
authors.forename: C
authors.initials: C
authors.lastname: Chabannon
authors.forename: L
authors.initials: L
authors.lastname: Xerri
authors.forename: B
authors.initials: B
authors.lastname: Chetaille
authors.forename: B
authors.initials: B
authors.lastname: Esterni
authors.forename: V
authors.initials: V
authors.lastname: Ivanov
authors.forename: A M
authors.initials: AM
authors.lastname: Stoppa
authors.forename: J M
authors.initials: JM
authors.lastname: Schiano de Collela
authors.forename: J A
authors.initials: JA
authors.lastname: Gastaut
authors.forename: D
authors.initials: D
authors.lastname: Maraninchi
authors.forename: R
authors.initials: R
authors.lastname: Bouabdallah
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D000069283:Rituximab; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D015251:Epirubicin; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D011241:Prednisone