PURPOSE: To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma. PATIENTS AND METHODS: LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), vincristine 1.4 mg/m(2), and prednisone 40 mg/m(2) for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m(2) was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle. RESULTS: Median follow-up is 5 years at present. Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the R-CHOP combination. CONCLUSION: Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.
RCT Entities:
PURPOSE: To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma. PATIENTS AND METHODS: LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), vincristine 1.4 mg/m(2), and prednisone 40 mg/m(2) for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m(2) was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle. RESULTS: Median follow-up is 5 years at present. Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the R-CHOP combination. CONCLUSION: Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.
Authors: Richard R Furman; Michael L Grossbard; Jeffrey L Johnson; Andrew L Pecora; Peter A Cassileth; Sin-Ho Jung; Bruce A Peterson; Lee M Nadler; Arnold Freedman; Ruthee-Lu Bayer; Nancy L Bartlett; David D Hurd; Bruce D Cheson Journal: Leuk Lymphoma Date: 2011-01-28
Authors: Wyndham H Wilson; Sin-Ho Jung; Pierluigi Porcu; David Hurd; Jeffrey Johnson; S Eric Martin; Myron Czuczman; Raymond Lai; Jonathan Said; Amy Chadburn; Dan Jones; Kieron Dunleavy; George Canellos; Andrew D Zelenetz; Bruce D Cheson; Eric D Hsi Journal: Haematologica Date: 2011-12-01 Impact factor: 9.941
Authors: Ranjana H Advani; Haiyan Chen; Thomas M Habermann; Vicki A Morrison; Edie A Weller; Richard I Fisher; Bruce A Peterson; Randy D Gascoyne; Sandra J Horning Journal: Br J Haematol Date: 2010-10 Impact factor: 6.998
Authors: Christian Gisselbrecht; Norbert Schmitz; Nicolas Mounier; Devinder Singh Gill; David C Linch; Marek Trneny; Andre Bosly; Noel J Milpied; John Radford; Nicolas Ketterer; Ofer Shpilberg; Ulrich Dührsen; Hans Hagberg; David D Ma; Andreas Viardot; Ray Lowenthal; Josette Brière; Gilles Salles; Craig H Moskowitz; Bertram Glass Journal: J Clin Oncol Date: 2012-10-22 Impact factor: 44.544