[Long-term results of rituximab-based salvage chemotherapy for relapsed or refractory diffuse large B-cell lymphoma].
OBJECTIVE
To investigate the efficacy and toxicity of rituximab-based salvage chemotherapy in the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL).


METHODS
Sixty-nine patients with relapsed or refractory DLBCL were treated by rituximab-based salvage chemotherapy, including 40 male and 29 female patients with a median age of 51.5 years (range 17 to 82 years). All the patients had prior treatments including of EPOCH, ICE, DHAP, GEMOX, and GDP. Twenty-seven patients also received rituximab treatment as the first-line regimen.


RESULTS
The objective response (OR) rate was 73.4% (47/64) in these patients with a complete response (CR) rate of 45.3%. The major adverse effects included bone marrow suppression, fatigue, and gastrointestinal toxicity. The side effects of rituximab were mild, including chill, fever and fatigue. The median follow-up was 40.6 (3.7-179.9) months. Twenty-eight patients died of tumor progression and two died from grade 4 myelosuppression accompanied by severe systemic infection. The median survival was 51.6 (3.7-179.9) months in this group. The 1, 3 and 5-year overall survival was 92%, 62% and 37%, respectively, and in patients without rituximab as the first line treatment, the overall survival at 1 and 3 years (97.4% and 73.5%) was much better than that in rituximab-treated patients (83.1% and 42.8%) (P=0.001). The patients of GCB subtype had better survival compared to the non-GCB subtype, with the 5-year overall survival of 42.3% and 21.4%, respectively (P=0.005).


CONCLUSIONS
Rituximab-based salvage regimens are effective and well tolerable, but further clinical trial is warranted.
Wang
Xiao-xiao
XX
Department of Medical Oncology, Cancer Center/State Key Laboratory of Oncology in South China/Sun Yat-sen Institute of Hematology, Sun Yat-sen University, Guangzhou 510060, China. 996xiaoxiao@163.com
Huang
Hui-qiang
HQ
Xia
Zhong-jun
ZJ
Lin
Xu-bin
XB
Cai
Qing-qing
QQ
Gao
Yan
Y
Lin
Ze-xiao
ZX
Lin
Tong-yu
TY
Jiang
Wen-qi
WQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D000069283:Rituximab; D016879:Salvage Therapy; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab