Improved survival with rituximab-based chemoimmunotherapy in older patients with extranodal diffuse large B-cell lymphoma.
Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we investigated the relative benefits of adding rituximab to CHOP chemotherapy in diffuse large B-cell lymphoma (DLBCL) of extranodal origin, and found similar advantage for nodal and extranodal lymphomas. Hazard ratio for overall survival was 0.64 for nodal, and 0.70 for extranodal DLBCL. Hazard ratios for lymphoma-related death were 0.62 and 0.57, respectively. The advantage was largest for DLBCL of the spleen, liver and lung. Conversely, it was not evident for thyroid or testicular lymphomas. Compared with nodal DLBCL, spleen was the only site with significantly better prognosis after R-CHOP.
The Cancer Center, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860, United States. Electronic address: adam_olszewski@brown.edu.
Adam J
AJ
Olszewski
Division of Hematology and Oncology, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, United States.
Eric S
ES
Winer
Division of Hematologic Malignancies, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States.
Jorge J
JJ
Castillo
D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D006278:Medicare; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D000069283:Rituximab; D018426:SEER Program; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014750:Vincristine / Q000627:therapeutic use
D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
Comparative effectiveness research; Diffuse large B-cell lymphoma; R-CHOP chemotherapy; Rituximab; SEER program