The effect of adding rituximab to CHOP-based therapy on clinical outcomes for Japanese patients with diffuse large B-cell lymphoma: a propensity score matching analysis.
We conducted a retrospective analysis to evaluate the impact on clinical outcomes of adding rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) treatment for diffuse large B-cell lymphoma (DLBCL) patients in Japan. A propensity score method was used to compensate for the non-randomized study design. From January 2000 to December 2004, 378 patients who were newly diagnosed with DLBCL at 13 institutes were enrolled: 123 in the rituximab plus CHOP-based chemotherapy (R+) group, and 255 in the CHOP-based chemotherapy only (R-) group. The complete response rate was significantly higher in the R+ group than in the R- group (77.7 vs. 69.4%, P < 0.001). The progression-free survival (PFS) at 2 years was 62.4% in the R+ group and 57.0% in the R- group. The 2-year overall survival (OS) was 76.9% for the R+ group and 70.5% for the R- group. A multivariate analysis revealed that the addition of rituximab was a strong independent prognostic factor for PFS (hazard ratio 0.64, 95% CI 0.43-0.96, P = 0.031). A subgroup analysis revealed that R+ particularly benefited younger patients (hazard ratio 0.25, 95% CI 0.08-0.75, P = 0.013). IPI also showed significant impact for PFS (hazard ratio 1.82, 95% CI 1.55-2.14 for one score increase, P < 0.001) as well as OS (hazard ratio 2.10, 95% CI 1.71-2.57, P < 0.001). In summary, the addition of rituximab to CHOP-based chemotherapy results in better outcomes for Japanese DLBCL patients, particularly younger patients.
Nishimori
Hisakazu
H
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Matsuo
Keitaro
K
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
Maeda
Yoshinobu
Y
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Nawa
Yuichiro
Y
Department of Hematology-Oncology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Sunami
Kazutaka
K
Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Togitani
Kazuto
K
Department of Hematology and Respiratory Medicine, Kochi Medical School, Nangoku, Japan.
Takimoto
Hidetaka
H
Department of Hematology, Kochi Medical Center, Kochi, Japan.
Hiramatsu
Yasushi
Y
Department of Hematology and Immunology, Kobe Nishi City Hospital, Kobe, Japan.
Kiguchi
Toru
T
Department of Internal Medicine, Kagawa Rosai Hospital, Marugame, Japan.
Yano
Tomofumi
T
Department of Hematology, Okayama Rosai Hospital, Okayama, Japan.
Yamane
Hiromichi
H
Department of Internal Medicine, Sumitomo-Besshi Hospital Cancer Center, Niihama, Japan.
Tabayashi
Takayuki
T
Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan.
Takeuchi
Makoto
M
Department of Hematology, National Hospital Organization Minami-Okayama Medical Center, Hayashima, Japan.
Makita
Masanori
M
Department of Internal Medicine, Saiseikai Nakatsu Hospital, Osaka, Japan.
Sezaki
Nobuo
N
Department of Internal Medicine, Kure Kyosai Hospital, Kure, Japan.
Yamasuji
Yoshiko
Y
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Sugiyama
Haruko
H
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Tabuchi
Takahiro
T
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Kataoka
Itaru
I
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Fujii
Nobuharu
N
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Ishimaru
Fumihiko
F
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Shinagawa
Katsuji
K
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Ikeda
Kazuma
K
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
Hara
Masamichi
M
Department of Hematology-Oncology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Yoshino
Tadashi
T
Division of Pathology, Okayama University Hospital, Okayama, Japan.
Tanimoto
Mitsune
M
Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan. tanimoto@md.okayama-u.ac.jp.