R‐CHOP‐14 in patients with diffuse large B‐cell lymphoma younger than 70 years: a multicentre, prospective study

Abstract

Several studies have shown that adding rituximab to CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) or reducing the interval between chemotherapy cycles from 3 weeks to 2 weeks improves survival in patients with diffuse large B‐cell lymphoma (DLBCL). These studies prompted our group (GOTEL) to evaluate prospectively in a pilot study the feasibility and efficacy of R‐CHOP‐14 in patients with DLBCL. Patients (<70 years) with stage II bulky or stage III or IV DLBCL and no significant comorbidities were included in the study. Rituximab was administered on day 1 before chemotherapy. R‐CHOP was given every 14 days. All patients received filgrastim (5 µg/kg) from days 4 to 10. From May 2002 to August 2004, 80 patients were recruited. Median age was 53 years and 58 patients were <60 years. According to the age‐adjusted international prognostic index (aaIPI), 13 patients (16%) had low‐risk disease, 31 (39%) low‐to‐intermediate risk, 27 (34%) high‐to‐intermediate risk and 9 (11%) high‐risk disease. Grade 3–4 neutropenia was observed in 15 patients (17.5%) and grade 3–4 infections in 13 patients (16%). After therapy, 58 patients (73%) achieved CR‐CRu (95% CI: 55–90%). With a median follow‐up of 26 months, progression‐free survival (PFS) and overall survival (OS) at 30 months were 72% and 86%, respectively. Administration of R‐CHOP‐14 is feasible and effective in patients <70 years. Copyright © 2007 John Wiley & Sons, Ltd.

Clinical experience with biweekly CHOP plus rituximab chemoimmunotherapy for the treatment of aggressive B-cell non-Hodgkin lymphoma

“…A prospective Italian cooperative group in 50 patients with DLBCL stage II-IV and all IPI groups reported a CR/CRu rate of 74% and a 2-year actuarial EFS of 72% [14]. The results of the Spanish Oncologic Group for the Treatment and Study of Lymphomas (GOTEL) study in patients with DLBCL younger than 70 years have also recently been reported [15]. A total of 80 patients were included and 58 (73%) achieved a CR/CRu.…”

“…In the MSKCC 16% developed grade 2 neuropathy and 71% grade 1, and 72% of the patients received the planned dose density of vincristine [13]. In the GOTEL study, grade 3 neurotoxicity was reported in 4 patients (5%) [15]. In the RICOVER60 trial rates of grade 3-4 neuropathy varied between 7 and 11% in the 4 groups of treatment with no signifi cant differences [17].…”

Comparison of R-CHOP21 Regimen with R-CHOP14 Regimen for Diffuse Large B-Cell Lymphoma

“…Aynı çalışmada genel sağkalım CHOP grubunda %68'e karşılık, R-CHOP14 grubunda %78 (p= 0.018) olarak bulunmuştur (5). GOTEL grubu (Oncologico para el Tratamiento y Estudio de los Linfomas) tarafından yapılan prospektif çok merkezli bir çalışmada hastalar R-CHOP14 ile tedavi edilmiş, hastaların %73'ünde tam remisyon, ortalama 26 aylık takip süresince progresyonsuz sağkalım ve genel sağkalım oranları sırasıyla %72 ve %86 olarak saptanmıştır (6). Çalışmamızda 30 aylık takip süresince R-CHOP14 grubu hastalarda genel sağkalım %85, olaysız sağkalım %76 olarak tespit edildi.…”

Biweekly rituximab, cyclophosphamide, vincristine, non‐pegylated liposome‐encapsulated doxorubicin and prednisone (R‐COMP‐14) in elderly patients with poor‐risk diffuse large B‐cell lymphoma and moderate to high ‘life threat’ impact cardiopathy

“…Elderly patients with newly diagnosed diffuse large B‐cell lymphoma (DLBCL) and a poor prognostic profile, according to the International Prognostic Index (IPI), were shown to benefit from shortening of the time interval between CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy cycles from 3 weeks (CHOP‐21) to 2 weeks (CHOP‐14) (Pfreundschuh et al , 2004, 2008). In these patients, biweekly CHOP plus rituximab (R) (R‐CHOP‐14) is regarded as a therapeutic standard for some cooperative groups and is a valuable option in clinical practice (Pfreundschuh et al , 2008; Rueda et al , 2008; Ziepert et al , 2010; Zwick et al , 2007).…”