Preview

Oncohematology

Advanced search

The efficacy of therapy with rituximab (R-CHOP) in patients with diffuse large cells lymphoma

https://doi.org/10.17650/1818-8346-2011-6-3-18-23

Abstract

This study aimed to evaluate treatment results in patients with diffuse large cell lymphoma (DBL CL) received R-CHOP program (as 1 st and
2 nd line therapy), including cases with complications. We observed 77 DBLCL patients (50 primary and 27 received other chemotherapy programs, in relapse, progression or treatment resistance phase). The median age is 54.1 years (21–79 years). 33 patients (43 %) had a high risk for unfavorable disease course according to IPI. Complications associated with development of severe compression syndromes, which required the appropriate surgical intervention, w as diagnosed in 45 (58.4 %) patients. From 50 primary patients received R-C HOP as the f irst line therapy objective treatment response was registered in 47 (94.0 %). Complete response was registered in 43 (86.0 %). The proportion of patients in whom response was maintained for 6 months w as 72.0 % in group with maintenance therapy and 28.0 % in group without it. These results were achieved when induction period density was 0.9. The last parameter is the ratio of the courses number to their time in mon ths. The density of standard induction R-C HOP-21 is 1.4. From 27 relapse or refractory patients received R-C HOP as the second line therapy objective
treatment response was registered in 85.1 % of patients. Induction period density w as 1.03. The proportion of patients in whom response was maintained for 6 months was 74.0 %. Three classes serum Ig concentrations analysis before and after induction period in 16 pati ents showed normal values. With the median (Me) follow-up time in all patients over 24 months 3-years survival w as 93 % and Me w as not achieved. 3-years survival was 100 % in primary patients and 80 % in patients with previously treatment, and Me is also not achieved.

About the Authors

T. D. Lutskaya
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


A. K. Golenkov
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


T. A. Mitina
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


I. V. Buravtsova
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


G. A. Dudina
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


L. L. Vysotskaya
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


E. V. Trifonova
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


E. V. Kataeva
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


O. V. Moskalets
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


V. V. Yazdovskiy
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation


References

1. Chesquieres H., Ferlay C., Derbel O. et al. Improvement of outcome in diffuse large B-cell lymphoma after introduction of rituximab in combination with chemotherapy, evaluation in daily practice in a cohort of 410 patients treated at a single institution between 1996 and 2008. Haematologica 2010;95(s2):281.

2. Cheson B.D., Homing S.J., Coffer B. et al. Report of an international workshop to standardize response criteria for non-Hodgkins lymphoma. J Clin Oncol 1999;17:1244–53.

3. Chiappella A., Cabras M.G., Liberati A.M. et al. Long-term outcome of 309 young patients with untreated diffuse B-cell lymphoma at poor profnosis: a pooled analysis from Gimulell and intergruppo italiano linfomi. Haematologica 2010;95(s2):279.

4. Coiffier B., Lepage E., Briere J., Herbrecht R., Tilly H., Bouabdallah R. et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large B-cell lymphoma. N Engl J Med 2002;346:235–42.

5. Czuczman M., Vose J., Zinzani P.L. et al. Lenadomide monotherapy is clinical active patients with relapsed or refractory diffuse large B-cell lymphoma. A pooled analysis of data from 2 phase studies(NHL-02/003).Haematologica 2010;95(s2):238.

6. Feugier P., van Hoor A., Sebban C., Solal-Celigny P., Bouabdallah R., Ferme C. et al. Long-term of the R-CHOP Study in the treatment of elderly patients with diffuse large B-cell lymphoma: A Study by the Groupe d’Etude des Lymphomes de l’Adulte. J. Clin Oncol 2005; 23:4117–26.

7. Filanovsky K., Shvidel L., Shtalrid M., Duek A. et al. Hypogammaglobulinemia and non-neutropenic infection after chemotherapy combined with rituximab. Predictive factors and clinical significance. Haematologica 2008;93(s1):104.

8. Haioun C., Jaeger U., Lugtenburg P., Rossi F., Salar A. et al. Risk of febrile neutropenia and use of G- SF ptimary prophilaxis in non-Hodgkin’s lymphoma patients receiving R-CHOP-21. Haematologica 2008;9351:105; abstr. 0258.

9. Herishanu Y., Terstman S., Perri C., Gipstein L., Ben-Tal O., Polliack A. et al. The combination of Rituximab, Etoposide, Ifosmide, and Carboplatin (RICE) is safe and effective salvage therapy for elderly patients with aggressive non-Hodgkin’s lymphoma. Haematologica 2005;90:999.

10. Kang H.J., Lim S.M., Choi C.W., Lee S.S., Na I.I., Ryoo B.Y. et al. Repeated radioimmunotherapy (RIT) with I-131 rituximab in patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma; preliminary results. Haematologica 2008;93(s1):100.

11. Kewalramani T., Zelenetz A.D., Nimer S.D., Portlock C., Straus D., Noy A. et al. Rituxiamab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma. Blood 2004;103:3684–8.

12. Munoz N., Gonzalez-Bucrea E. et al. Primary nodal diffuse large B-cell lymphoma stage 1-II. Clinicobiological features and prognostic factors experience in a single institution. Haematologica 2010;95(s2):622.

13. Mey U.J., Olivieri A., Orlopp K.S., Rabe C., Strehl J.W., Gorschlueter M. et al. DHAP in combination with rituximab vs DHAP alone as salvage treatment for patients with relapsed or refractory diffuse large B-cell lymphoma; a matched-pair analysis. Leuk Lymphoma 2006; 47:2558–66.

14. Pregno P., Chiappella A., Bello M. et al. The outcome of diffuse large B-cell lymphomapatients treated with R-CHOP is not predict by interim evaluation of 18 FDG-position emission tomography or computed tomography (PET). Haematologica 2010;95(s2):285.

15. Prochazka V., Treny M., Pytlik R. et al. Clinical findings and treatment of elderly patients with diffuse large B-cell lymphoma: the analysis og the 1425 patients included in Czech lymphoma project. Haematologica 2010;95(s2):279.

16. Salar A., Saumell S., Pedro C., Alvarez-Larran A., Gimeno E., Abella E. et al. Rituximab maintenance significantly prolongs time to progression in patients with relapsed follicular lymphoma and also achieves a long term disease control in De Novo follicular lymphoma. Haematologica 2008;93(s1):110; abstr. 0271.

17. Sikder A., Dhakaj S., Kelly J. et al. Early stage diffuse large B-cell lymphoma in the R-CHOP. Era: Does involved field radiation therapy (IFRT) impact outcome? Blood 2007;110(s11):1006a.

18. Todd T., Karanth M., Jackson D. et al. Tolerance of R-CHOP-21 for diffuse large B-cell lymphoma in an unselected population and impact of dose reduction on outcome. Haematologica 2010;95(s2):282.

19. Verhoef G., Dang N., Smith M., Offer F. et al. Anti CD-22 immunoconjugate inotuzumab ozogamicin (CMC-544) plus rituximab: clinical activity in patients with relapsed or refractory follicular or

20. aggressive lymphoma. Haematologica 2010; 95(s2):238.

21. Zelenetz A.D., Hamlin P., Kewalramani T., Yahalom J., Nimer S., Moskowitz C.H. Ifosfamide, carboplatin, etoposide (ICE) based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin’s lymphoma. Ann Oncol 2003; 14 Suppl 1:i5–10.


Review

For citations:


Lutskaya T.D., Golenkov A.K., Mitina T.A., Buravtsova I.V., Dudina G.A., Vysotskaya L.L., Trifonova E.V., Kataeva E.V., Moskalets O.V., Yazdovskiy V.V. The efficacy of therapy with rituximab (R-CHOP) in patients with diffuse large cells lymphoma. Oncohematology. 2011;6(3):18-23. (In Russ.) https://doi.org/10.17650/1818-8346-2011-6-3-18-23

Views: 12149


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)