Rituximab Enhances CHOP in Aggressive Lymphomas

[Guest guest]

[it is being used in Richter's as well]

Rituximab Enhances Chemotherapy in Lymphoma Patients

NEW YORK (Reuters Health) Apr 10 - In young and relatively young

lymphoma patients, addition of the monoclonal antibody, rituximab, to

standard chemotherapy improves survival, researchers report in an

April 5th online edition of The Lancet Oncology.

Dr. Pfreundschuh of Saarland University Medical School,

Hamburg, Germany and colleagues note that rituximab along with

cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP)-

like chemotherapy has proved successful in elderly patients.

To investigate whether this might also be the case in those aged 18

to 60 years, the researchers studied 824 such patients with good-

prognosis CD20-positive diffuse large B-cell lymphoma.

They were randomized to 6 cycles of CHOP-like chemotherapy with or

without rituximab. Bulky and extranodal sites were treated with

radiotherapy.

Three-year event-free survival rates were 79% among patients in the

combination group, versus 59% of those given CHOP alone. For overall

survival, the corresponding rates were 93% and 84%.

In the CHOP group there were 57 lymphoma-associated and one treatment-

related death. In the combination group, there were 19- lymphoma-

associated and 6 treatment-related deaths.

An age-adjusted International Prognostic Index (aaIPI) score of zero

and lack of bulky disease was associated with a better prognosis than

was the case for those without either or both of these favorable

factors.

Dr. Pfreundschuh told Reuters Health that " while the results of the

very favorable subgroup... can hardly be improved any further, the

results in the less favorable subgroup -- all patients with aaIPI=1,

and patients with aaIPI=0 and bulky disease -- definitely need

further improvement. "

Nonetheless, say the investigators, the effect of rituximab overall

was greater than that expected on the basis of the earlier results in

elderly patients. In fact, the team concludes that the need for

salvage therapy in these younger patients " could be halved by the

addition of rituximab. "

Lancet Oncol 2006.

Reuters Health Information 2006. © 2006 Reuters Ltd.