Study On The Treatment With Chemotherapy Or Immuno-chemotherapy For The Patients With Diffuse Large B Cell Lymphoma

PurposeFor more than two decades, cyclophosphamide, doxorubixin, vincrinstin, and prednisone (CHOP) has been the standard therapy for diffuse large B-cell lymphoma (DLBCL). The addition of Retuximab to CHOP has been shown to improve outcome in elderly patients with DLBCL. We conduct a population-based analysis to asses the impact of this combination therapy on patients with DLBCL in Cancer Hospital of Chinese Academy of Medicine Sciences (CH, CAMS).MethodsDuring the Uan.2003.-31.Dec.2007, Untreated DLBCL (CD20 positive) 153 patients were divided two groups: to treatment with CHOP /CHOP-like alone (69patients) or chemotherapy plus Rituximab (84 patients) at an dose (every 3weeks) of 375mg/m~2. The primary end point was event-free survival; secondary end points were complete response (CR), partial response (PR), overall survival, and safety.ResultsA total of 153 patients were evaluated; 69 in the chemotherapy group (median follow-up, 30months) and 84 in the Rituximab Plus chemotherapy group (median follow-up, 27months). Both event-free survival (risk ratio 0.27, 95% CI 0.11 to 0.65; p=0.004) and overall survival (risk ratio 0.35, 95% CI 0.14 to 0.85; p=0.02) were significantly improved in the Rituximab Plus chemotherapy group. The univariate analysis indicated that International Prognostic Index (IPI) and the organ numbers of tumor involved were significant prognostic factors, with P values of 0.01 and 0.05 respectively. The multivariates Cox regression analysis demonstrated that IPI, and the combination of the Rituximab appear to impact on survival, with P values of 0.05, 0.004 respectively.ConclusionThe addition of Rituximab to CHOP chemotherapy has resulted in a dramatic improvement in outcome for young or elderly DLBCL patients in our hospital.