Universität zu Köln

Glass, B., Ziepert, M., Reiser, M., Freund, M., Truemper, L., Metzner, B., Feller, A., Loeffler, M., Pfreundschuh, M. and Schmitz, N. (2010). High-dose therapy followed by autologous stem-cell transplantation with and without rituximab for primary treatment of high-risk diffuse large B-cell lymphoma. Ann. Oncol., 21 (11). S. 2255 - 2262. OXFORD: OXFORD UNIV PRESS. ISSN 0923-7534

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Abstract

Background: We aimed to determine safety and efficacy of rituximab (R) in combination with repetitive high-dose therapy (HDT) as primary treatment for diffuse large B-cell lymphoma (DLBCL). Patients and methods: Patients aged 18-60 years and elevated lactate dehydrogenase were treated with four cycles of MegaCHOEP and transplantation of autologous stem cells after cycles 2, 3 and 4. Rituximab (375 mg/m(2)) was given before each cycle and 12 and 33 days after start of the last cycle of chemotherapy. Sixty-four patients given R-MegaCHOEP were compared with 29 patients who had received identical treatment without rituximab. Results: Overall survival (OS) and event-free survival (EFS) after 3 years were significantly improved in patients treated with R-MegaCHOEP (OS: 78.7% versus 55.0%, P = 0.045; EFS: 72.7% versus 47.2%, P = 0.013). In a Cox regression model adjusted for performance status and stage, relative risk of treatment failure was lower (relative risk 0.5, P = 0.041) and OS was better (relative risk 0.4, P = 0.054) for patients given R-MegaCHOEP. Grade 3/4 infections were more frequent in the R-MegaCHOEP group (18.5% versus 6.0%, P = 0.003). Conclusions: The addition of rituximab to MegaCHOEP significantly improved outcome in young patients with high-risk DLBCL. The higher incidence of grade 3/4 infections needs consideration when rituximab and HDT regimens are combined.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Glass, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ziepert, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reiser, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Freund, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Truemper, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Metzner, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Feller, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loeffler, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfreundschuh, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitz, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-492873
DOI:	10.1093/annonc/mdq235
Journal or Publication Title:	Ann. Oncol.
Volume:	21
Number:	11
Page Range:	S. 2255 - 2262
Date:	2010
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	0923-7534
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NON-HODGKINS-LYMPHOMA; BONE-MARROW TRANSPLANTATION; PROGNOSIS AGGRESSIVE LYMPHOMA; CHEMOTHERAPY PLUS RITUXIMAB; CHOP CHEMOTHERAPY; ETOPOSIDE MEGACHOEP; INITIAL TREATMENT; ELDERLY-PATIENTS; YOUNG-PATIENTS; TRIAL Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/49287