Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Japan: a retrospective analysis of 1,057 cases from Kyushu Lymphoma Study Group.
We performed a retrospective analysis of patients with diffuse large B cell lymphoma treated with rituximab plus CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) as a first-line therapy at 22 hospitals of the Kyushu Lymphoma Study Group. During the period 1996-2005, 1,057 patients (aged 22-90 years) were analyzed. Of these, 678 were treated with CHOP, and 379 were treated with rituximab plus CHOP (R-CHOP). The complete response rate was 59.9% in the CHOP group and 67.0% in the R-CHOP group (P < 0.001). Three-year progression-free survival (PFS) and overall survival (OS) rates were significantly higher in the R-CHOP group than in the CHOP group (61.3 vs. 45.6% for PFS, P < 0.001; 68.3 vs. 54.5% for OS, P < 0.001). The International Prognostic Index was a good prognostic marker for both groups; a survival benefit of rituximab addition was found for each risk subgroup and also for both age groups (<or=60 and >60 years). Among 345 patients who received localized radiation therapy, the adding rituximab to CHOP attenuated the survival difference between CHOP and R-CHOP groups (P = 0.104), compared with no radiation group (P < 0.001). Results of this large-scale, multicenter study confirm that rituximab plus CHOP provided a greater survival benefit than CHOP alone.
Seki
Ritsuko
R
Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
Ohshima
Koichi
K
Nagafuji
Koji
K
Fujisaki
Tomoaki
T
Uike
Naokuni
N
Kawano
Fumio
F
Gondo
Hisashi
H
Makino
Shigeyoshi
S
Eto
Tetsuya
T
Moriuchi
Yukiyoshi
Y
Taguchi
Fumihiro
F
Kamimura
Tomohiko
T
Tsuda
Hiroyuki
H
Ogawa
Ryosuke
R
Shimoda
Kazuya
K
Yamashita
Kiyoshi
K
Suzuki
Keiko
K
Suzushima
Hitoshi
H
Tsukazaki
Kunihiro
K
Higuchi
Masakazu
M
Utsunomiya
Atae
A
Iwahashi
Masahiro
M
Imamura
Yutaka
Y
Tamura
Kazuo
K
Suzumiya
Junji
J
Yoshida
Minoru
M
Abe
Yasunobu
Y
Matsumoto
Tadashi
T
Okamura
Takashi
T
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011241:Prednisone / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D014750:Vincristine / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone