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Role of rituximab in the first-line therapy of high-risk diffuse large B-cell lymphoma: a retrospective analysis by the Polish Lymphoma Research Group
DOI: 10.20452/pamw.3113
Published online: September 03, 2015
INTRODUCTION R-CHOP immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine,
prednisone) is a standard first-line treatment for diffuse large B-cell lymphoma (DLBCL). None of the
randomized trials have proved a statistically significant overall survival (OS) benefit in high-risk subgroups
according to the International Prognostic Index (IPI).
OBJECTIVES We retrospectively investigated the role of adding rituximab to anthracycline-based chemotherapy
in patients with high-risk DLBCL according to the IPI.
PATIENTS AND METHODS A total of 371 patients with high-risk DLBCL treated at 15 Polish hematology
centers were retrospectively analyzed in 2 distinct age groups: older than 60 years and 60 years old or
younger. Response rates, OS, and progression-free survival (PFS) were compared and analyzed.
RESULTS The overall response rate (ORR) of high-risk DLBCL patients significantly improved in rituximabtreated
patients compared with patients treated without rituximab (76.7% vs 95.6%; P <0.05). The R-CHOP
immunochemotherapy prolonged survival in both older and younger subgroups. The 5-year projected OS
and PFS in younger patients treated with rituximab vs chemotherapy alone were 42% vs 38% and 46%
vs 27%, respectively (P <0.05), while the 5-year projected OS and PFS in older patients treated with
rituximab vs chemotherapy alone were 82% vs 52% and 67% vs 45%, respectively (P <0.05).
CONCLUSIONS With all the limitations of a retrospective analysis, the superiority of adding rituximab
to CHOP combination chemotherapy has been clearly demonstrated regarding ORR, OS, and PFS in both
age subgroups of patients with high-risk DLBCL.
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