title: 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.
abstract: 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.
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Nishimori
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Department of Hematology-Oncology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Nawa
authors.affiliation: Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Sunami
authors.affiliation: Department of Hematology and Respiratory Medicine, Kochi Medical School, Nangoku, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Togitani
authors.affiliation: Department of Hematology, Kochi Medical Center, Kochi, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Takimoto
authors.affiliation: Department of Hematology and Immunology, Kobe Nishi City Hospital, Kobe, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hiramatsu
authors.affiliation: Department of Internal Medicine, Kagawa Rosai Hospital, Marugame, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kiguchi
authors.affiliation: Department of Hematology, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Yano
authors.affiliation: Department of Internal Medicine, Sumitomo-Besshi Hospital Cancer Center, Niihama, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Yamane
authors.affiliation: Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tabayashi
authors.affiliation: Department of Hematology, National Hospital Organization Minami-Okayama Medical Center, Hayashima, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Internal Medicine, Saiseikai Nakatsu Hospital, Osaka, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Makita
authors.affiliation: Department of Internal Medicine, Kure Kyosai Hospital, Kure, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sezaki
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Yamasuji
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Haruko
authors.initials: H
authors.lastname: Sugiyama
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tabuchi
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Kataoka
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Fujii
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Ishimaru
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shinagawa
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Hematology-Oncology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hara
authors.affiliation: Division of Pathology, Okayama University Hospital, Okayama, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Shikata-cho 2-5-1, Okayama, Okayama, 700-8558, Japan. tanimoto@md.okayama-u.ac.jp.
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto