Efficacy and Adverse Effects of Rituximab Combined with a TCOP Regimen in Patients with Untreated Diffuse Large B-cell Lymphoma and Follicular Lymphoma

Abstract

: Pirarubicin tetrahydropyranyl adriamycin : THP is a doxorubicin DOX derivative with lower cardiotoxicity than DOX. However, there is little information on clinical outcome and toxicity in patients treated with an R-TCOP regimen including this drug rituximab, THP, cyclophosphamide, vincristine, and prednisolone . We retrospectively analyzed the efficacy and safety of R-TCOP compared to TCOP in patients with diffuse large B-cell lymphoma DLBCL n 91 or follicular lymphoma FL n 25 . In cases of DLBCL, the median follow-up times for surviving patients were 864 days in the TCOP group n 41 and 430 days in the R-TCOP group n 50 . Patients treated with R-TCOP showed a significantly better response to treatment than those treated with TCOP P 0.01 and a significantly longer three-year overall survival OS 70 for R-TCOP vs. 50 for TCOP, P 0.02 . Factors influencing the improved OS with R-TCOP treatment were age 60 years, clinical stage IV disease, International Prognostic Index HI-risk and H-risk, serum lactate dehydrogenase normal, performance status ≥2, B symptoms, extranodal sites ≥2, and bone marrow involvement. In a Cox proportional hazard model, the addition of rituximab was associated with good OS. In cases of FL, the response to treatment, OS, and progressionfree survival did not differ signi cantly between the two regimens. Adverse events including cardiac toxicities did not differ signi cantly between R-TCOP and TCOP treatment, and there were no deaths associated with adverse events. OS was signi cantly improved among IPI HI-risk or H-risk cases and in advanced-stage patients with DLBCL who received R-TCOP compared to those receiving TCOP. The incidence of adverse events did not differ between the two regimens.