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Medical Oncology

, Volume 23, Issue 2, pp 283–293 | Cite as

Outcome for young high-risk aggressive B-cell lymphoma patients treated with CHOEP-14 and rituximab (R-CHOEP-14)

  • Magdalena Adde
  • Gunilla Enblad
  • Hans Hagberg
  • Christer Sundström
  • Anna Laurell
Original Article

Abstract

Purpose

To study the effectiveness and tolerability of a dose-intensified treatment including rituximab for patients, not older than 65 yr, with high-risk aggressive B-cell lymphoma.

Patients

Thirty-eight patients with high-risk aggressive B-cell lymphoma, the majority classified as grade 2 or 3 using age-adjusted International Prognostic Index, were treated with six courses of CHOEP+rituximab on a 2-wk schedule with G-CSF d 4-11. CNS prophylaxis was administered using intravenous Ara-C as a single dose at the end of treatment.

Results

All patients were considered responders after three courses. Thirty-one patients (82%) achieved a complete remission or a complete remission unverified. With a median follow up of 27 mo, overall and event-free survival are 79% and 60%, respectively. Treatment was given on an outpatient basis. There were no treatment-related unexpected toxic events or mortalities. Large-cell lymphoma involvement of the bone marrow was a poor prognostic sign even with this intensified treatment and 4/6 patients relapsed. CNS relapse occurred in three patients, two of whom had large cell bone marrow involvement.

Conclusion

Although only a short follow up, the R-CHOEP-14 regimen is promising and could be an improvement compared to conventional treatment, with acceptable toxicity. The value of intravenous Ara-C at the end of treatment can be questioned, as it did not prevent CNS relapse or affect treatment outcome.

Key Words

High-risk aggressive B-cell lymphoma dose-intensified treatment rituximab 

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Copyright information

© Humana Press Inc. 2005

Authors and Affiliations

  • Magdalena Adde
    • 1
  • Gunilla Enblad
    • 1
  • Hans Hagberg
    • 1
  • Christer Sundström
    • 2
  • Anna Laurell
    • 1
  1. 1.Department of OncologyUppsala University HospitalUppsalaSweden
  2. 2.Department of PathologyUppsala University HospitalUppsalaSweden

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