Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte
- PMID: 15867204
- DOI: 10.1200/JCO.2005.09.131
Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte
Abstract
Purpose: To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma.
Patients and methods: LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), vincristine 1.4 mg/m(2), and prednisone 40 mg/m(2) for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m(2) was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle.
Results: Median follow-up is 5 years at present. Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the R-CHOP combination.
Conclusion: Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.
Similar articles
-
Immuno-fluorescence in situ hybridization index predicts survival in patients with diffuse large B-cell lymphoma treated with R-CHOP: a GELA study.J Clin Oncol. 2009 Nov 20;27(33):5573-9. doi: 10.1200/JCO.2009.22.7058. Epub 2009 Sep 28. J Clin Oncol. 2009. PMID: 19786664 Clinical Trial.
-
CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma.N Engl J Med. 2002 Jan 24;346(4):235-42. doi: 10.1056/NEJMoa011795. N Engl J Med. 2002. PMID: 11807147 Clinical Trial.
-
Cost utility in the United States of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone for the treatment of elderly patients with diffuse large B-cell lymphoma.Cancer. 2005 Apr 15;103(8):1644-51. doi: 10.1002/cncr.20956. Cancer. 2005. PMID: 15756658
-
Evolution of R-CHOP therapy for older patients with diffuse large B-cell lymphoma.Expert Rev Anticancer Ther. 2008 Oct;8(10):1651-8. doi: 10.1586/14737140.8.10.1651. Expert Rev Anticancer Ther. 2008. PMID: 18925856 Review.
-
Long-term follow-up of a prospective study of combined modality therapy for stage I-II indolent non-Hodgkin's lymphoma.J Clin Oncol. 2003 Jun 1;21(11):2115-22. doi: 10.1200/JCO.2003.07.111. J Clin Oncol. 2003. PMID: 12775737 Review.
Cited by
-
Synchronous Anal Squamous Cell Carcinoma and Diffuse Large B Cell Lymphoma of Stomach: the First Report of an Odd Couple.Indian J Surg Oncol. 2024 Sep;15(3):457-462. doi: 10.1007/s13193-024-01927-9. Epub 2024 Mar 19. Indian J Surg Oncol. 2024. PMID: 39239451 Review.
-
Diffuse large B-cell lymphoma in the C8 root mimicking a schwannoma: illustrative case.J Neurosurg Case Lessons. 2024 Aug 19;8(8):CASE24338. doi: 10.3171/CASE24338. Print 2024 Aug 19. J Neurosurg Case Lessons. 2024. PMID: 39159499 Free PMC article.
-
Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: The STRIDER study.Cancer Med. 2024 Jul;13(14):e7448. doi: 10.1002/cam4.7448. Cancer Med. 2024. PMID: 39030982 Free PMC article.
-
Novel Targets and Advanced Therapies in Diffuse Large B Cell Lymphomas.Cancers (Basel). 2024 Jun 17;16(12):2243. doi: 10.3390/cancers16122243. Cancers (Basel). 2024. PMID: 38927948 Free PMC article. Review.
-
Appropriate Treatment Intensity for Diffuse Large B-Cell Lymphoma in the Older Population: A Review of the Literature.Hematol Rep. 2024 May 24;16(2):317-330. doi: 10.3390/hematolrep16020032. Hematol Rep. 2024. PMID: 38921180 Free PMC article. Review.
Publication types
MeSH terms
Substances
Supplementary concepts
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials