title: Clinical Outcome of Rituximab-Based Therapy (RCHOP) in Diffuse Large B-Cell Lymphoma Patients with Bone Marrow Involvement.
abstract: OBJECTIVE
  We investigated the clinical outcome of bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy.
  
  
  METHODS
  A total of 567 consecutive patients with newly diagnosed DLBCL treated with rituximab-CHOP (RCHOP) between November 2001 and March 2010 were included in the current study. All of the patients underwent a BM study at the initial staging and the clinical characteristics and prognosis of these patients with or without BM involvement were analyzed retrospectively.
  
  
  RESULTS
  The total cohort included 567 patients. The overall incidence of BM involvement was 8.5%. With a median follow-up duration of 33.2 months (range, 0.1 to 80.7 months) for patients who were alive at the last follow-up, the five-year overall survival (OS) and event-free survival (EFS) rate in patients without BM involvement (76.3% and 67.5%, p<0.001) was statistically higher than that in patients with BM involvement (44.3% and 40.1%, p<0.001). In multivariate analysis, among total patients, BM involvement showed a significant association with OS and EFS. In univariate and multivariate analyses, even among stage IV patients, a significant association with worse EFS was observed in the BM involvement group.
  
  
  CONCLUSIONS
  BM involvement at diagnosis affected the survival of patients with DLBCL who received RCHOP. Although use of RCHOP can result in significant improvement of the therapeutic effect of DLBCL, BM involvement is still a negative prognostic factor of DLBCL patients in the era of rituximab.
authors.affiliation: Department of Hematology/Oncology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Byung Woog
authors.initials: BW
authors.lastname: Kang
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Yee Soo
authors.initials: YS
authors.lastname: Chae
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Lee
authors.forename: Jong Gwang
authors.initials: JG
authors.lastname: Kim
authors.forename: Yeo-Kyeoung
authors.initials: YK
authors.lastname: Kim
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Hyeoung-Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Young Rok
authors.initials: YR
authors.lastname: Do
authors.forename: Keon Uk
authors.initials: KU
authors.lastname: Park
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Song
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Kwon
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Kim
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Lee
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Hyun
authors.forename: Hun Mo
authors.initials: HM
authors.lastname: Ryoo
authors.forename: Sung Hwa
authors.initials: SH
authors.lastname: Bae
authors.forename: Hwak
authors.initials: H
authors.lastname: Kim
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
keywords: Bone marrow; Diffuse large B-cell lymphoma; Rituximab