R-CHOP regimen can significantly decrease the risk of disease relapse and progression in patients with non-germinal center B-cell subtype diffuse large B-cell lymphoma.
- Author:
Xiao-Hui HE
1
;
Bo LI
;
Sheng YANG
;
Ning LU
;
Xun ZHANG
;
Shuang-Mei ZOU
;
Ye-Xiong LI
;
Yong-Wen SONG
;
Shan ZHENG
;
Mei DONG
;
Sheng-Yu ZHOU
;
Jian-Liang YANG
;
Peng LIU
;
Chang-Gong ZHANG
;
Yan QIN
;
Feng-Yi FENG
;
Yuan-Kai SHI
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived; therapeutic use; Antineoplastic Agents; therapeutic use; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Cyclophosphamide; therapeutic use; Disease Progression; Disease-Free Survival; Doxorubicin; analogs & derivatives; therapeutic use; Female; Follow-Up Studies; Germinal Center; pathology; Humans; Interferon Regulatory Factors; metabolism; Lymphoma, Large B-Cell, Diffuse; drug therapy; metabolism; pathology; Male; Middle Aged; Neprilysin; metabolism; Prednisone; therapeutic use; Proportional Hazards Models; Proto-Oncogene Proteins c-bcl-2; metabolism; Proto-Oncogene Proteins c-bcl-6; metabolism; Recurrence; Retrospective Studies; Rituximab; Survival Rate; Vincristine; therapeutic use; Young Adult
- From:Chinese Journal of Cancer 2012;31(6):306-314
- CountryChina
- Language:English
- Abstract: To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype (non-GCB) diffuse large B-cell lymphoma(DLBCL), 159 newly diagnosed DLBCL patients were studied retrospectively based on the immunohistochemical evaluation of CD10, Bcl-6, MUM-1, and Bcl-2. Altogether, 110 patients underwent the CHOP-like regimen, and rituximab was added for the other 49 patients. Cox regression analysis showed that compared with the CHOP-like regimen, the rituximab-based regimen(R-CHOP regimen) significantly decreased the risk of disease relapse and progression in CD10-negative patients (P=0.001), Bcl-6-negative patients (P=0.01), and MUM-1-positive patients (P=0.003). The risk of disease relapse in patients with non-GCB subtype (P=0.002) also decreased. In contrast, patients with the opposite immunohistochemical marker expression profile and GCB subtype did not benefit from treatment with the R-CHOP regimen. In addition, non-GCB subtype patients had a significantly higher expression rate of Bcl-2 than GCB subtype patients (P=0.042). Although univariate analysis found that both Bcl-2-positive and -negative patients had significantly higher event-free survival rates with the R-CHOP regimen, only Bcl-2 positivity (P=0.004) maintained significance in the Cox regression analysis. We conclude that the addition of rituximab can significantly improve the prognosis of patients with non-GCB subtype DLBCL, which is closely related to the expression of CD10, Bcl-6, MUM-1, and Bcl-2.
