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.