Clinical Investigation Of Rituximab In Combination With CHOP Chemotherapy For Diffuse Large B Cell Lymphoma

BACKGROUND & OBJECTIVE CHOP regimen is the standard treatment for patients with diffuse large B-cell lymphoma. Rituximab,an anti-CD20 monoclonal antibody, is effective in treating diffuse large B-cell lymph- oma with CD20(+).This study was conducted to compare the efficacy and toxicity of rituximab plus CHOP (R-CHOP)and CHOP alone on newly diagnosed or refractory patients with diffuse large B-cell lymphoma,and analyze their toxicities. METHODS We summarize the information of 39 cases newly diagnosed or refractory patients with diffuse large B-cell lymphoma from nov-2001 to today by the research method of non-concurrent control retros- pecty in our hospital.16 cases received CHOP plus rituximab with 4～6 courses ,23 cases received CHOP with 4～6 courses.Each course lasted 3 weeks . All cases were evaluated after 3th and 6th courses about efficacy and toxicity. RESULTS With a median follow-up of 28.2 months(2.2～75.2 months),The total response rate in R-CHOP group was 93.8%,among which complete remission was seen in 4 patients and partial remission was seen in 11 patients;while the total response rate in CHOP group was 52.2%, among which complete remission was seen in 1 patients and partial remission was seen in 11 patients .The therapeutic efficacy was significantly better in R-CHOP group than in CHOP group (P<0.05). The 1-year or 2-year progress- ion-freely and 2-year overall survival rates were significantly higher in R-CHOP group than in CHOP group(62.5%vs26.1% ,56.3%vs21.7%,56.3%vs21.7%, P<0.05).R-CHOP group were similar to CHOP group in adverse effect incidence rate(93.8%vs69.7%,P>0.05).The adverse events incidence rate was 12.5% about infusion-related response (increased heart rate,febrile,abdominal distention,dyspnea,etc) in R-CHOP group,Severity of adverse effect degree was light which could be well tolerated.Clinically relevant toxicity (bone marrow depression,nausea,vomiting,liver toxicity,etc) was similar in both groups. CONCLUSIONS : Rituximab increases the therapeutic efficacy of CHOP regimen on newly diagnosed or refractory patients with diffuse large B-cell lymphoma ,and doesn,t increase the occurrence of chemotherapy-related adverse events. Rituximab plus CHOP can be used as a first-line greatest therapy of diffuse large B-cell lymphoma.