title: Dose-intensified CHOP with rituximab (R-Double-CHOP) followed by consolidation high-dose chemotherapies for patients with advanced diffuse large B-cell lymphoma.
abstract: Even after the advent of rituximab, clinical outcomes of conventional immuno-chemotherapy for high-risk diffuse large B-cell lymphoma (DLBCL) remain unsatisfactory. We retrospectively evaluated the efficacy and safety of R-Double-CHOP (R-D-CHOP), consisting of rituximab (375 mg/m(2), day -2), cyclophosphamide (750 mg/m(2), day 1, 2), doxorubicin (50 mg/m(2), day 1, 2), vincristine [1.4 mg/m(2) (maximum 2.0 mg/body), day 1], and prednisolone (50 mg/m(2), day 1-5), followed by consolidation high-dose chemotherapy. This treatment was given to 51 de novo DLBCL patients with a median age of 54 (range 19-65), who were categorized as high/high-intermediate risk by the age-adjusted International Prognostic Index. Treatment was given every 3 weeks up to three courses. The overall response and the complete response rate for R-D-CHOP were 94 and 78 %, respectively. A total of 30 responders proceeded to high-dose chemotherapy followed by autologous stem cell transplantation (HDC/ASCT), whereas 16 received high-dose methotrexate (HD-MTX) alternatively. The 3-year overall survival and the event-free survival for all patients were 78 and 61 %, respectively. Major adverse events included hematological toxicities, but there were no treatment-related deaths during the observation period. We conclude that the R-D-CHOP regimen followed by HDC/ASCT or HD-MTX is a promising treatment option for younger patients with highly advanced DLBCL.
authors.affiliation: Department of Hematology and Rheumatology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurita
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Miura
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Shimon
authors.initials: S
authors.lastname: Ohtake
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakagami
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Uchino
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Satomi
authors.initials: S
authors.lastname: Kiso
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hojo
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kodaira
authors.forename: Mai
authors.initials: M
authors.lastname: Yagi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: Yujin
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Iriyama
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hatta
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugitani
authors.forename: Masami
authors.initials: M
authors.lastname: Takei
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone