Journal of Cancer Research and Clinical Oncology

, Volume 138, Issue 1, pp 125–132

How to determine post-RCHOP therapy for risk-tailored adult patients with diffuse large B-cell lymphoma, addition of maintenance rituximab or observation: multicenter experience

  • Bin-Tao Huang
  • Qing-Chun Zeng
  • Jessica Yu
  • Zhen Xiao
  • Bing-Sheng Li
  • Chun-Lai Zhang
  • Hong-Bo Ji
Original Paper

DOI: 10.1007/s00432-011-1074-1

Cite this article as:
Huang, B., Zeng, Q., Yu, J. et al. J Cancer Res Clin Oncol (2012) 138: 125. doi:10.1007/s00432-011-1074-1

Abstract

Background

In international prognostic index (IPI) risk-tailored adult patients with diffuse large B-cell lymphoma (DLBCL), it is still unclear whether the addition of maintenance rituximab (MR) improves progression-free (PFS) and overall survival (OS), after RCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) therapy.

Methods

In our study, 207 patients (age: 21–59 years) received six 14-day cycles of RCHOP and gained overall response. After RCHOP, 98 patients were enrolled in the observation (OBS) arm. 109 patients continued to receive MR therapy.

Results

In IPI risk <2 profile, PFS at 5 years reached 72.9% (MR arm) versus 56% (OBS arm) (P = 0.033). In IPI risk ≥2 profile, PFS estimation at 5 years was 44.9% (MR arm) versus 33.5% (OBS arm) (P = 0.006). It is noteworthy that patients with IPI ≥2 who received MR achieved PFS similar to that for patients in the OBS arm with the IPI <2, 44.9% versus 56% (P = 0.97). In patients with an IPI <2, OS at 5 years was 83.2% (MR arm) versus 81.2% (OBS arm) (P = 0.708). In patients with an IPI ≥2, 5-year OS estimation was 44.6% (MR arm) versus 40.5% (OBS arm) (P = 0.067). Subgroup analysis of patients with an IPI ≥3 risk profile shows a survival benefit for patients receiving MR. OS at 5 years was 62% (MR arm) versus 49% (OBS arm), (P = 0.033).

Conclusions

In conclusion, maintenance rituximab after RCHOP improves progression-free survival. In addition, overall survival is improved for patients with an IPI ≥3 risk profile receiving MR.

Keywords

RituximabDiffuse large B-cell lymphomaRCHOP-14International Prognostic IndexAdult patients

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Bin-Tao Huang
    • 1
  • Qing-Chun Zeng
    • 2
  • Jessica Yu
    • 3
  • Zhen Xiao
    • 1
  • Bing-Sheng Li
    • 4
  • Chun-Lai Zhang
    • 5
  • Hong-Bo Ji
    • 6
  1. 1.Department of HematologyThe Affiliated Hospital of Inner Mongolia Medical CollegeHohhotPeople’s Republic of China
  2. 2.Department of MedicineThe Affiliated Hospital of Guangdong Medical CollegeZhanjiangPeople’s Republic of China
  3. 3.Department of SurgeryUniversity of Colorado School of MedicineAuroraUSA
  4. 4.Huizhou Medicine InstituteHuizhouPeople’s Republic of China
  5. 5.Department of MedicineThe First People’s Hospital of ChenzhouChenzhouPeople’s Republic of China
  6. 6.Department of MedicineChifeng Municipal HospitalChifengPeople’s Republic of China