title: The addition of rituximab to front-line therapy with CHOP (R-CHOP) results in a higher response rate and longer time to treatment failure in patients with lymphoplasmacytic lymphoma: results of a randomized trial of the German Low-Grade Lymphoma Study Group (GLSG).
abstract: Lymphoplasmacytic lymphoma (LPL) is an indolent lymphoma with moderate sensitivity to conventional chemotherapy. This study investigated whether the addition of rituximab to standard chemotherapy improves treatment outcome in LPL and the subgroup of LPL patients fulfilling the criteria of Waldenstroem's macroglobulinemia (WM). A total of 69 patients with previously untreated LPL were enrolled into the trial; 64 patients were evaluable for treatment outcome. In all, 48 of the 64 LPL patients fulfilled the criteria of WM. Patients were randomly assigned to R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone, n=34) or CHOP (n=30). R-CHOP resulted in significantly higher overall response (OR) rate (94 vs 67%, P=0.0085) in the LPL patients and in the WM subgroup (91 vs 60%, P=0.0188). With a median observation time of 42 months, R-CHOP induced a significantly longer time to treatment failure (TTF) with a median of 63 months for R-CHOP vs 22 months in the CHOP arm in the LPL patients (P=0.0033) and in the WM subgroup (P=0.0241). There was no major difference of treatment-associated toxicity between both treatment groups. These data indicate that the addition of rituximab to front-line chemotherapy improves treatment outcome in patients with LPL or WM.
authors.affiliation: Department of Internal Medicine III, University of Munich, Munich, Germany. christian.buske@med.uni-muenchen.de
authors.forename: C
authors.initials: C
authors.lastname: Buske
authors.forename: E
authors.initials: E
authors.lastname: Hoster
authors.forename: M
authors.initials: M
authors.lastname: Dreyling
authors.forename: H
authors.initials: H
authors.lastname: Eimermacher
authors.forename: H
authors.initials: H
authors.lastname: Wandt
authors.forename: B
authors.initials: B
authors.lastname: Metzner
authors.forename: R
authors.initials: R
authors.lastname: Fuchs
authors.forename: J
authors.initials: J
authors.lastname: Bittenbring
authors.forename: B
authors.initials: B
authors.lastname: Woermann
authors.forename: K
authors.initials: K
authors.lastname: Hohloch
authors.forename: G
authors.initials: G
authors.lastname: Hess
authors.forename: W-D
authors.initials: WD
authors.lastname: Ludwig
authors.forename: J
authors.initials: J
authors.lastname: Schimke
authors.forename: S
authors.initials: S
authors.lastname: Schmitz
authors.forename: M
authors.initials: M
authors.lastname: Kneba
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.forename: U
authors.initials: U
authors.lastname: Graeven
authors.forename: W
authors.initials: W
authors.lastname: Klapper
authors.forename: M
authors.initials: M
authors.lastname: Unterhalt
authors.forename: W
authors.initials: W
authors.lastname: Hiddemann
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000633:toxicity; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone