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Previous Volume 346:235-242 January 24, 2002 Number 4 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Cheson, B. D. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The standard treatment for patients with diffuse large-B-cell lymphoma is cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Rituximab, a chimeric monoclonal antibody against the CD20 B-cell antigen, has therapeutic activity in diffuse large-B-cell lymphoma. We conducted a randomized trial to compare CHOP chemotherapy plus rituximab with CHOP alone in elderly patients with diffuse large-B-cell lymphoma.

Methods Previously untreated patients with diffuse large-B-cell lymphoma, 60 to 80 years old, were randomly assigned to receive either eight cycles of CHOP every three weeks (197 patients) or eight cycles of CHOP plus rituximab given on day 1 of each cycle (202 patients).

Results The rate of complete response was significantly higher in the group that received CHOP plus rituximab than in the group that received CHOP alone (76 percent vs. 63 percent, P=0.005). With a median follow-up of two years, event-free and overall survival times were significantly higher in the CHOP-plus-rituximab group (P<0.001 and P=0.007, respectively). The addition of rituximab to standard CHOP chemotherapy significantly reduced the risk of treatment failure and death (risk ratios, 0.58 [95 percent confidence interval, 0.44 to 0.77] and 0.64 [0.45 to 0.89], respectively). Clinically relevant toxicity was not significantly greater with CHOP plus rituximab.

Conclusions The addition of rituximab to the CHOP regimen increases the complete-response rate and prolongs event-free and overall survival in elderly patients with diffuse large-B-cell lymphoma, without a clinically significant increase in toxicity.

Source Information

From the Hospices Civils de Lyon and the Université Claude Bernard, Lyons (B.C., G.S.); Hôpital Henri-Mondor, Paris (E.L., P.G., F.R.); Assistance Publique–Hôpitaux de Paris, Hôpital Saint-Louis, Paris (J.B., C.G.); Hôpital de Hautepierre, Strasbourg (R.H.); the Centre Becquerel, Rouen (H.T.); the Institut Paoli-Calmette, Marseilles (R.B.); and the Centre Hospitalier de Lens (P.M.) — all in France; and the Université Catholique de Louvain, Brussels, Belgium (E.N.).

Pierre Lederlin, Ph.D., Centre Hospitalier Universitaire de Brabois, Nancy, France, was also an author.

Address reprint requests to Dr. Coiffier at the Service d'Hématologie, Centre Hospitalier Lyon-Sud, 69495 Pierre Bénite CEDEX, France, or at bertrand.coiffier{at}chu-lyon.fr.

Full Text of this Article

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Rituximab plus CHOP for Diffuse Large-B-Cell Lymphoma
Akhtar S., Maghfoor I., Coiffier B., Gisselbrecht C., Reyes F.
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N Engl J Med 2002; 346:1830-1831, Jun 6, 2002. Correspondence

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