title: Randomized, Double-Blind, Phase III Trial of Enzastaurin Versus Placebo in Patients Achieving Remission After First-Line Therapy for High-Risk Diffuse Large B-Cell Lymphoma.
abstract: To compare disease-free survival (DFS) after maintenance therapy with the selective protein kinase C β (PKCβ) inhibitor, enzastaurin, versus placebo in patients with diffuse large B-cell lymphoma (DLBCL) in complete remission and with a high risk of relapse after first-line therapy.
  
  
  
  This multicenter, phase III, randomized, double-blind, placebo-controlled trial enrolled patients who were at high risk of recurrence after rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Patients (N = 758) with stage II bulky or stage III to IV DLBCL, three or more International Prognostic Index risk factors at diagnosis, and a complete response or unconfirmed complete response after 6 to 8 cycles of R-CHOP were assigned 2:1 to receive oral enzastaurin 500 mg daily or placebo for 3 years or until disease progression or unacceptable toxicity. Primary end point was DFS 3 years after the last patient entered treatment. Correlative analyses of biomarkers, including cell of origin by immunohistochemistry and PKCβ expression, with efficacy outcomes were exploratory objectives.
  
  
  
  After a median follow-up of 48 months, DFS hazard ratio for enzastaurin versus placebo was 0.92 (95% CI, 0.689 to 1.216; two-sided log-rank P = .541; 4-year DFS, 70% v 71%, respectively). Independent of treatment, no significant associations were observed between PKCβ protein expression or cell of origin and DFS or overall survival.
  
  
  
  Enzastaurin did not significantly improve DFS in patients with high-risk DLBCL after achieving complete response to R-CHOP. Achievement of a complete response may have abrogated the prognostic significance of cell of origin by immunohistochemistry.
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China. michael.crump@uhn.ca.
authors.forename: Michael
authors.initials: M
authors.lastname: Crump
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Leppä
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Luis
authors.initials: L
authors.lastname: Fayad
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Je Jung
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Alice
authors.initials: A
authors.lastname: Di Rocco
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Michinori
authors.initials: M
authors.lastname: Ogura
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Hans
authors.initials: H
authors.lastname: Hagberg
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Frederick
authors.initials: F
authors.lastname: Schnell
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Robert
authors.initials: R
authors.lastname: Rifkin
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mackensen
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Fritz
authors.initials: F
authors.lastname: Offner
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Lauren
authors.initials: L
authors.lastname: Pinter-Brown
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Sonali
authors.initials: S
authors.lastname: Smith
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Su-Peng
authors.initials: SP
authors.lastname: Yeh
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Hsi
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Tuan
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Peipei
authors.initials: P
authors.lastname: Shi
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Marjo
authors.initials: M
authors.lastname: Hahka-Kemppinen
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Don
authors.initials: D
authors.lastname: Thornton
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Boris
authors.initials: B
authors.lastname: Lin
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Brad
authors.initials: B
authors.lastname: Kahl
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Savage
authors.affiliation: Michael Crump, Princess Margaret Cancer Centre, Toronto, Ontario; Kerry J. Savage, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Sirpa Leppä, Helsinki University Hospital Cancer Center, Helsinki, Finland; Luis Fayad, The University of Texas MD Anderson Cancer Center, Houston, TX; Frederick Schnell, Central Georgia Cancer Care, Macon, GA; Robert Rifkin, US Oncology Research Network and Rocky Mountain Cancer Centers, Denver, CO; Lauren Pinter-Brown, University of California at Los Angeles, Santa Monica, CA; Sonali Smith, University of Chicago, Chicago, IL; Eric D. Hsi, Cleveland Clinic, Cleveland, OH; Tuan Nguyen, Peipei Shi, Marjo Hahka-Kemppinen, Don Thornton, and Boris Lin, Eli Lilly and Company, Indianapolis, IN; Brad Kahl, University of Wisconsin, Madison, WI; Thomas Habermann, Mayo Clinic Cancer Research Consortium, Rochester, NY; Je Jung Lee, Chonnam National University Hwasun Hospital, Gwangju, South Korea; Alice Di Rocco, Sapienza University, Rome, Italy; Michinori Ogura, Tokai Central Hospital, Kakamigahara; Kensei Tobinai, National Cancer Center Hospital, Tokyo, Japan; Hans Hagberg, Akademiska Sjukhuset, Onkologkliniken, Uppsala, Sweden; Andreas Mackensen, University of Erlangen, Erlangen; Norbert Schmitz, Asklepios Klinik St Georg, Hamburg, Germany; Fritz Offner, University of Gent, Gent, Belgium; and Su-Peng Yeh, China Medical University Hospital, Taichung, Republic of China.
authors.forename: Thomas
authors.initials: T
authors.lastname: Habermann
mesh_terms: 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; D003520:Cyclophosphamide / Q000627:therapeutic use; D004311:Double-Blind Method; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D064546:Protein Kinase C beta / Q000032:analysis / Q000037:antagonists & inhibitors*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D000069283:Rituximab; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007211:Indoles; D047428:Protein Kinase Inhibitors; D019253:Proto-Oncogene Proteins c-bcl-2; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D064546:Protein Kinase C beta; C504878:enzastaurin; D011241:Prednisone