Short-term efficacy of rituximab-CHOP and CHOP regimens on two subtypes of diffuse large B-cell lymphoma.
OBJECTIVE
Diffuse large B-cell lymphoma (DLBCL) can be divided into two subgroups as germinal center B-cell like (GCB) and non-GCB DLBCL, according to the origin of tumor cells. The prognosis of GCB DLBCL is better than that of non-GCB DLBCL after receiving the CHOP regimen on initial therapy. This study was to compare the short-term efficacy of rituximab(R)-CHOP and CHOP regimens on GCB and non-GCB DLBCL, thus to explore the optimal first-line regimen for the initial treatment of DLBCL patients.


METHODS
In total, eighty-three patients with de novo DLBCL initially treated at Sun Yat-sen University Cancer Center from November 2006 to February 2008 were enrolled. Patients were divided into GCB and non-GCB groups. The short-term efficacy of the CHOP or R-CHOP regimen as the first-line therapy on the two groups was evaluated according to the revised response criteria for lymphoma. Bcl-2 expression and its correlation to the short-term efficacy of the two groups were assessed.


RESULTS
There were 35 cases (42.2%) in the GCB group and 48 cases (57.8%) in the non-GCB group. The total remission rate was 74.3% in the GCB group and 60.4% in the non-GCB group (p = 0.006). There was no significant difference in Bcl-2 expression in the two groups. The remission rate was higher in Bcl-2 positive patients receiving R-CHOP regimen than those receiving CHOP regimen (75.6% vs. 47.8%, p = 0.023). There was no significant difference in the remission rate of Bcl-2 negative patients, regardless of chemotherapy regimen.


CONCLUSIONS
The prognosis is better in the GCB group than in the non-GCB group. Addition of rituximab to CHOP could improve the short-term efficacy of Bcl-2 positive patients.
Xia
Yi
Y
State Key Laboratory of Oncology in South China, Department of Medical Oncology, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Li
Zhi-Ming
ZM
Shi
Yan-Xia
YX
Xia
Zhong-Jun
ZJ
Jiang
Wen-Qi
WQ
Huang
Hui-Qiang
HQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000951:Antigens, Neoplasm / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004268:DNA-Binding Proteins / Q000378:metabolism; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000378:metabolism; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D051560:Proto-Oncogene Proteins c-bcl-6; D012074:Remission Induction; D000069283:Rituximab; D013997:Time Factors; D016896:Treatment Outcome; D033921:Vesicular Transport Proteins / Q000378:metabolism; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000951:Antigens, Neoplasm; C084103:BCL6 protein, human; D004268:DNA-Binding Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; C401314:TRAPPC1 protein, human; D033921:Vesicular Transport Proteins; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D015260:Neprilysin; D011241:Prednisone