Randomized intergroup trial of first line treatment for patients &lt;=60 years with diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) with a CHOP-like regimen with or without the anti-CD20 antibody rituximab -early stopping after the first interim analysis

Pfreundschuh, M; Trümper, Lorenz; Ma, Dan; Österborg, Anders; Pettengell, Ruth; Trněný, Marek; Shepherd, Leah; Waleswski, J.; Zinzani, PL; Loeffler, Markus

doi:10.1200/jco.2004.22.90140.6500

Cited by 40 publications

(16 citation statements)

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“…4 9 Furthermore, a recent study in younger patients suggested an equally beneficial effect. 10 As a result, rituxan/CHOP has been adopted as standard treatment for patients with advanced stage DLBCL. The precise mechanism by which rituxan Table 2 Exocrine and systemic manifestations and serological profile of the study patients Sjögren's syndrome associated non-Hodgkin's lymphoma induces anti-tumour or anti-B-cell effects is not clearly understood.…”

Section: Discussionmentioning

confidence: 99%

Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Voulgarelis

Giannouli²,

Tzioufas³

et al. 2006

Annals of the Rheumatic Diseases

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Section: Discussionmentioning

confidence: 99%

Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Voulgarelis

Giannouli²,

Tzioufas³

et al. 2006

Annals of the Rheumatic Diseases

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“…Late relapses also suggested that optimal treatment may include more or different systemic chemotherapy. Recent reports suggest that rituximab plus CHOP is more effective than CHOP alone in more advanced stage DLBCL ( 19,20 ) and the standard treatment for early stage DLBCL patients may be changed in the near future. ( 21 )…”

Section: Discussionmentioning

confidence: 99%

Japanese multicenter phase II study of CHOP followed by radiotherapy in stage I–II₁, diffuse large B‐cell lymphoma of the stomach

Ishikura

Tobinai²,

Ohtsu

et al. 2005

Cancer Science

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CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) followed by radiotherapy is regarded as standard care for localized aggressive lymphoma; however, prospective confirmation of its applicability to localized primary gastric lymphoma is inadequate, and most patients in Japan have been initially treated with gastrectomy. We conducted a multicenter phase II study to evaluate the feasibility and efficacy of the non-surgical treatment. P rimary gastric lymphoma (PGL) is the most common among extranodal non-Hodgkin's lymphomas. PGL includes various histologic subtypes and management decisions are made depending on these subtypes. Eradication of Helicobacter pylori can achieve a 60-90% complete response for localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma,(1) and this stomach-preserving treatment has been rapidly accepted. In contrast, the optimal treatment of localized gastric diffuse large B-cell lymphoma (DLBCL) still remains controversial. Surgery, alone or followed by chemotherapy with or without radiotherapy (RT), has been used as a primary therapy (2)(3)(4)(5) and has been supported by many physicians. Stomach-preserving treatment with chemotherapy with or without RT has also been reported with encouraging results, but no definitive conclusion could be drawn because most series were retrospective with small numbers of patients, heterogeneous histologic subtypes and various combinations of treatment. (6 -10) CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) has been used as a standard chemotherapy for DLBCL and three cycles of CHOP followed by RT has also been accepted for localized DLBCL.(11) However, prospective clinical trials to confirm its applicability to primary gastric DLBCL have rarely been conducted. To evaluate the feasibility and efficacy of nonsurgical treatment, we conducted a multicenter phase II study. Materials and methodsEligibility criteria and pretreatment evaluation. Eligibility criteria were as follows: pathologically proven primary gastric DLBCL; stage I-II 1 (Lugano staging system for gastrointestinal (GI) lymphomas (12) ); age 20 -75; performance status (based on Eastern Cooperative Oncology Group scale) 0 -1; no prior therapy; and adequate organ function. All patients gave written informed consent in accordance with our institutional review boards.Pretreatment evaluation included history and physical examination, complete blood count, serum chemistries, gastroscopy with biopsy, barium enema or colonoscopy, endoscopic ultrasound of the stomach, computed tomography (CT) scan of the chest and the abdomen, bone marrow aspiration, electrocardiogram and cardiac ultrasonography. Gallium scintigram and barium swallow were optional.Treatment details. The treatment consisted of three cycles of CHOP (day 1: cyclophosphamide, 750 mg/m 2 ; day 1: doxorubicin, 50 mg/m 2 , day 1: vincristine, 1.4 mg/m 2 (capped at 2 mg); and days 1-5: oral prednisone, 100 mg) every 3 weeks. RT delivered with megavoltage equipment began 3 -4 weeks after the third cycle ...

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“…Uvodenje monoklonskog anti-CD20 antitela rituksimaba u terapiju DKBL dovelo je do znacajnog poboljsanja rezultata leccnja, a R-CHOP protokol ucinilo novim zlatnirn standardom prve linije terapije DKBL [8,9].…”

Section: Uvodunclassified

Prognostic factors in patients with diffuse large B-cell lymphoma

Uzurov-Dinic

Savić

Lazarevic³

et al. 2009

Med pregl

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Diffuse large B-cell lymphoma is an aggressive type of lymphoma, potentially curable, with heterogeneous prognosis. The aim of this study was to determine prognostic significance of clinical, laboratory and immunohystochemical factors. The retrospective study was done in 50 patients with diffuse large B-cell lymphoma. The following parameters were investigated: demographic (age, sex), clinical (time to diagnosis, B symptoms, clinical stage), laboratory (erythrocyte sedimentarion rate, haemoglobin, lactate dehydrogenase, albumine), standard and revised international prognostic index, and immunohystochemical parameters, cluster designation 20, B-cell-2, and Ki67 expression. There were 20 females and 30 males, their average age being 54 (22-83) years. The majority of patients had advanced disease: B symptoms in 76%, III and IV stage in 78%, increased lactate dehydrogenase in 74%, high risk standard international prognostic index in 62% of patients. B-cell leukemia/lymphoma 2 expression was found in 57%, and high Ki67 in 62% of patients. Rituximab-Cyclophosphamnide, Hydroxydaunorubicin, Vincristine, Prednisolone and Rituximab-Cyclophosphamide, Hydroxydaunorubicin, Vincristine, Etoposide, Prednisolone were conducted in 72% (36), and Cyclophosphamide, Hydroxydaunorubicin, Vincristine, Prednisolone and Cyclophosphamide, Hydroxydaunorubicin, Vincristine, Prednisolone-like treatment in 28% (14) of patients. The complete remission rate was 74%, and the partial remission rate was 9%. A significant difference in survival was found between low intermediate and high intermediate S-IPI risk groups, good and bad risk R-IPI, and patients with complete remission and patients with other treatment responses. The other parameters, including Bcl-2 and Ki67 expression, and type of treatment did not show significant influence on survival. The expected five-year survival was 69%. Our results have shown that international prognostic index, and complete remission status have prognostic significance in diffuse large B-cell lymphomas.

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Randomized intergroup trial of first line treatment for patients <=60 years with diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) with a CHOP-like regimen with or without the anti-CD20 antibody rituximab -early stopping after the first interim analysis

Cited by 40 publications

References 0 publications

Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Japanese multicenter phase II study of CHOP followed by radiotherapy in stage I–II₁, diffuse large B‐cell lymphoma of the stomach

Prognostic factors in patients with diffuse large B-cell lymphoma

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Randomized intergroup trial of first line treatment for patients <=60 years with diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) with a CHOP-like regimen with or without the anti-CD20 antibody rituximab -early stopping after the first interim analysis

Cited by 40 publications

References 0 publications

Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Japanese multicenter phase II study of CHOP followed by radiotherapy in stage I–II1, diffuse large B‐cell lymphoma of the stomach

Prognostic factors in patients with diffuse large B-cell lymphoma

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Japanese multicenter phase II study of CHOP followed by radiotherapy in stage I–II₁, diffuse large B‐cell lymphoma of the stomach