title: Non-Hodgkin lymphomas: impact of rituximab on overall survival of patients with diffuse large B-cell and follicular lymphoma.
abstract: OBJECTIVE
  Information comparing treatment outcome for diffuse large B cell (DLBCL) and follicular (FL) non-Hodgkin lymphoma (NHL) patients treated with schemes with and without rituximab from low- and middle-income countries is scarce. Clinical characteristics, response to therapy and long-term outcome of DLBCL and FL patients were studied.
  
  
  METHODS
  Patients with DLBCL and FL diagnosed over 8 years at a reference center in northeast Mexico were included. Kaplan-Meier method was used to determine overall survival (OS) and progression-free survival (PFS). Cox regression model was used to evaluate the association between risk factors, rituximab therapy and clinical outcome.
  
  
  RESULTS
  One hundred-sixteen patients with DLBCL and 65 with FL in advanced stages were included. Median age was 57.8 and 56 years, respectively. Clinical characteristics between groups receiving or not receiving rituximab were comparable. Stages III and IV were found in 63.8% of DLBCL and 84.6% in FL patients, respectively. OS and PFS at 60 months were 63.8 and 51.2% in DLBCL and 70.6 and 33.8% in FL. No difference in OS was found in DLBCL and FL when rituximab-based regimens vs. non rituximab-based regimens were compared, but a statistically significant difference was documented in PFS in FL patients.
  
  
  CONCLUSIONS
  Addition of rituximab to CHOP-like regimens did not improve OS in DLBCL and FL NHL subtypes. In comparison to developed countries, diagnosis of NHL was made a decade earlier and in advanced clinical stages. Cost-efficiency of adding rituximab to therapy for these patients should be assessed.
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México. Electronic address: carjaime@hotmail.com.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Jaime-Pérez
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Carmen Magdalena
authors.initials: CM
authors.lastname: Gamboa-Alonso
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Alberto
authors.initials: A
authors.lastname: Vázquez-Mellado de Larracoechea
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Marisol
authors.initials: M
authors.lastname: Rodríguez-Martínez
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: César Homero
authors.initials: CH
authors.lastname: Gutiérrez-Aguirre
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Marfil-Rivera
authors.affiliation: Internal Medicine Division, Department of Hematology, "Dr. José Eleuterio González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: David
authors.initials: D
authors.lastname: Gómez-Almaguer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000069283:Rituximab
keywords: Diffuse large B-cell lymphoma; Follicular lymphoma; Non-Hodgkin lymphoma; Rituximab