The effect of adding rituximab to CHOP-based therapy on clinical outcomes for Japanese patients with diffuse large B-cell lymphoma: a propensity score matching analysis

Nishimori, Hisakazu; Matsuo, Keitaro; Maeda, Yoshinobu; Nawa, Yuichiro; Sunami, Kazutaka; Togitani, Kazuto; Takimoto, Hidetaka; Hiramatsu, Yasushi; Kiguchi, Toru; Yano, Tomonori; Yamane, Hiromichi; Tabayashi, Takayuki; Takeuchi, Makoto; Makita, Masanori; Sezaki, Nobuo; Yamasuji, Yoshiko; Sugiyama, Haruko; Tabuchi, Takahiro; Kataoka, Itaru; Fujii, Nobuharu; Ishimaru, Fumihiko; Shinagawa, Katsuji; Ikeda, Kazuma; Hara, Masamichi; Yoshino, Tadashi; Tanimoto, Mitsune

doi:10.1007/s12185-009-0259-8

Cited by 8 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no significant difference in patients who had been treated with R-CHOP like therapy compared to those who were treated with CHOP-like chemotherapy without rituximab. These results are in contrary to many other published results (Coiffer et al, 2002;Feugier et al, 2005;Sehn et al, 2005;Pfreundschuh et al, 2006;Nishimori et al, 2009). The most likely explanation for this would be the inadequate dose of rituximab.…”

Section: Discussioncontrasting

confidence: 99%

“…The results from European Groupe D'Estude des Lymphomes des L'Adulte LNH-98-5 study (GELA) study demonstrated that 5 year overall survival (OS) is significantly higher in elderly patients with rituximab combination chemotherapy (Coiffer et al, 2002). In younger patients who had R-CHOP like chemotherapy had an increased 3-year event-free survival and OS compared to those without rituximab; 79% vs 59% and 93% vs 84% respectively (Pfreundschuh et al, 2006) More recently, the Asia groups including the Japanese, Korean, Chinese and Singaporean had also confirmed similar findings in patients with DLBCL (Park et al, 2006;Li et al, 2007;Ngo et al, 2008;Nishimori et al, 2009;Seiki et al, 2010). However, within the Asian countries, there are many which have limited health care resources in treating patients with lymphoma.…”

Section: Introductionmentioning

confidence: 78%

“…R-CHOP or CHOP like chemotherapy has proven to improve overall survival of patients with aggressive NHL (Coiffer et al, 2002;Feugier et al, 2005;Sehn et al, 2005;Pfreundschuh et al, 2006). The results are indisputable and many studies done within Asia region had also proven so (Park et al, 2006;Li et al, 2007;Nishimori et al, 2009). A study which evaluated the outcomes of Western and Asian patients with DLBCL treated with R-CHOP found no difference in OS and progression free survival (PFS) (Castillo et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Inadequate Doses of Rituximab in the Treatment of Diffuse Large B Cell Lymphoma in Malaysian Patients

Gan

Subramaniam²,

Bee³

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: The current standard treatment for patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) is rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP). A significant number of patients were not treated with recommended dose of rituximab due to limited financial resources in Malaysia. This study evaluates the efficacy of R-CHOP like chemotherapy in Malaysian patients with DLBCL. Materials and Methods: The study comprised a retrospective analysis of patients with DLBCL treated at a single centre. The outcome was compared with patients who were treated with R-CHOP like and CHOP like chemotherapy. Patients who were treated with lower dose of rituximab was subanalysed for outcome. Results: A total of 86 patients who had CHOP-like chemotherapy were included. Only 39 (45%) patients had rituximab and only 12 (29%) patients had the recommended dose. The overall response (OR) and complete response (CR) rates were 88% and 81% respectively. There was no significant difference in OR and CR in patients who had rituximab and those without rituxmab. Those with International Prognostic Index (IPI) score of ≤2 had significant higher CR rate, progression free survival (PFS) and overall survival (p<0.001). Conclusions: The lack of significant improvement in CR and DFS in our patients may be due to an inadequate dose of rituximab.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Inadequate Doses of Rituximab in the Treatment of Diffuse Large B Cell Lymphoma in Malaysian Patients

Gan

Subramaniam²,

Bee³

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…[13][14][15] Since the introduction of rituximab, several prognostic factors have been reevaluated in DLBCL patients, [16][17][18] but the prognostic value of HCV infection in rituximab combination chemotherapy has not been well established. In addition, hepatitis B virus (HBV) reactivation is a well-documented complication that occurs frequently after introduction of rituximab.…”

Section: Introductionmentioning

confidence: 99%

Hepatic toxicity and prognosis in hepatitis C virus–infected patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy regimens: a Japanese multicenter analysis

Ennishi

Maeda

Niitsu

et al. 2010

Blood

Self Cite

121

119

View full text Add to dashboard Cite

The influence of hepatitis C virus (HCV) infection on prognosis and hepatic toxicity in patients with diffuse large B-cell lymphoma in the rituximab era is unclear. Thus, we analyzed 553 patients, 131 of whom were HCV-positive and 422 of whom were HCV-negative, with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP)-like chemotherapy. Survival outcomes and hepatic toxicity were compared according to HCV infection. The median follow-up was 31 and 32 months for patients who were HCV-positive and HCV-negative, respectively. HCV infection was not a significant risk factor for prognosis (3-year progression-free survival, 69% vs 77%, P ‫؍‬ .22; overall survival, 75% vs 84%, P ‫؍‬ .07). Of 131 patients who were HCV-positive, 36 (27%) had severe hepatic toxicity (grade 3-4), compared with 13 of 422 (3%) patients who were HCV-negative. Multivariate analysis revealed that HCV infection was a significant risk factor for severe hepatic toxicity (hazard ratio: 14.72; 95% confidence interval, 6.37-34.03; P < .001). An exploratory analysis revealed that pretreatment transaminase was predictive of severe hepatic toxicity. HCV-RNA levels significantly increased during immunochemotherapy (P ‫؍‬ .006). These results suggest that careful monitoring of hepatic function and viral load is indicated during immunochemotherapy for HCV-positive patients. (Blood. 2010; 116(24):5119-5125)

show abstract

“…The antitumor effect of rituximab is mediated by antibody‐dependent cell‐mediated cytotoxicity (ADCC), complement‐dependent cytotoxicity (CDC), antibody‐mediated phagocytosis of tumor cells and rituximab‐induced apoptosis . Several trials have demonstrated that the addition of rituximab to conventional chemotherapy improved the response rate and prolonged the survival of DLBCL patients . Therefore, rituximab is included in the R‐CHOP, R‐EPOCH, R‐ESHAP and R‐GEMOX regimens recommended for DLBCL treatment .…”

mentioning

confidence: 99%

Gemcitabine enhances rituximab‐mediated complement‐dependent cytotoxicity to B cell lymphoma by CD20 upregulation

et al. 2016

View full text Add to dashboard Cite

Although rituximab, a chimeric monoclonal antibody that specifically binds to CD20, has significantly improved the prognosis for diffuse large B cell lymphoma (DLBCL), one‐third of DLBCL patients demonstrate resistance to rituximab or relapse after rituximab treatment. Thus, a novel approach to rituximab‐based treatment is likely to be required to improve the efficacy of DLBCL treatment. As complement dependent cytotoxicity (CDC) is a key mechanism mediating rituximab's tumoricidal activity, rituximab binding to CD20 on tumor cells is a critical factor for effective rituximab‐based treatments against DLBCL. We found that gemcitabine (GEM), but not lenalidomide (LEN) or azacitidine (AZA), can upregulate CD20 expression in TK and KML‐1 cells, two human DLBCL cell lines. Treatment of TK and KML‐1 cells with GEM enhanced CD20 expression at both the mRNA and protein levels. CD20 upregulation by GEM treatment was accompanied by increased rituximab binding to CD20. In TK cells, GEM treatment synergistically increased rituximab‐mediated CDC activity in a dose‐dependent manner. In KML cells, GEM treatment also induced upregulation of complement regulatory proteins, possibly leading to resistance to CDC. Treatment with LEN, a drug that did not upregulate CD20, did not enhance rituximab‐mediated CDC activity. GEM treatment activated nuclear factor‐kappa B (NF‐kB) signaling in these cells. Furthermore, a specific inhibitor to NF‐kB suppressed GEM‐induced CD20 upregulation, indicating that GEM‐induced NF‐kB activation is closely associated with CD20 upregulation. These results suggest that when used in combination, GEM might enhance the antitumor efficacy of rituximab against DLBCL due to its unique ability to upregulate CD20.

show abstract

The effect of adding rituximab to CHOP-based therapy on clinical outcomes for Japanese patients with diffuse large B-cell lymphoma: a propensity score matching analysis

Cited by 8 publications

References 24 publications

Impact of Inadequate Doses of Rituximab in the Treatment of Diffuse Large B Cell Lymphoma in Malaysian Patients

Impact of Inadequate Doses of Rituximab in the Treatment of Diffuse Large B Cell Lymphoma in Malaysian Patients

Hepatic toxicity and prognosis in hepatitis C virus–infected patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy regimens: a Japanese multicenter analysis

Gemcitabine enhances rituximab‐mediated complement‐dependent cytotoxicity to B cell lymphoma by CD20 upregulation

Contact Info

Product

Resources

About