Rituximab-dose-dense chemotherapy with or without high-dose chemotherapy plus autologous stem-cell transplantation in high-risk diffuse large B-cell lymphoma (DLCL04): final results of a multicentre, open-label, randomised, controlled, phase 3 study

Chiappella, Annalisa; Martelli, Maurizio; Angelucci, Emanuele; Brusamolino, Ercole; Evangelista, Andrea; Carella, Angelo Michele; Stelitano, Caterina; Rossi, Giuseppe; Balzarotti, Monica; Merli, Francesco; Gaïdano, Gianluca; Pavone, Vincenzo; Rigacci, Luigi; Zaja, Francesco; D’Arco, Alfonso Maria; Cascavilla, Nicola; Russo, Eleonora; Castellino, Alessia; Gotti, Manuel; Congiu, Angela Giovanna; Cabras, Maria Giuseppina; Tucci, Alessandra; Agostinelli, Claudio; Ciccone, Giovannino; Pileri, Stefano; Vitolo, Umberto

doi:10.1016/s1470-2045(17)30444-8

Cited by 110 publications

(140 citation statements)

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“…Several large randomised studies have confirmed a survival benefit when rituximab was added to CHOP1617 with the proportion of patients alive at two years from diagnosis increasing from 57% to 70% in elderly patients and the proportion alive at three years in younger patients increasing from 84% to 93%. Many trials have examined more intensive regimens and the use of bone marrow or stem cell transplantation as first line treatment of DLBCL 1819. However, none of these has yet demonstrated an improvement in patient overall survival when compared with standard R-CHOP.…”

Section: How Is Non-hodgkin Lymphoma Treated?mentioning

confidence: 99%

Non-Hodgkin lymphoma

Al-Naeeb

Ajithkumar

Behan

et al. 2018

BMJ

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Section: How Is Non-hodgkin Lymphoma Treated?mentioning

confidence: 99%

Non-Hodgkin lymphoma

Al-Naeeb

Ajithkumar

Behan

et al. 2018

BMJ

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“…During the last 2 decades, the clinical outcome of patients with non‐Hodgkin lymphoma (NHL) has improved dramatically because of the availability of new treatment options, such as noncytotoxic drugs that specifically target disease mechanisms . The efficacy of rituximab and the lack of its cross‐resistance with chemotherapy make it an attractive candidate for incorporation into existing chemotherapy regimens, including high‐dose intensification and autologous stem cell transplantation (ASCT) …”

Section: Introductionmentioning

confidence: 99%

Long‐term fatigue in survivors of non‐Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross‐sectional study

Mounier¹,

Anthony

Busson³

et al. 2019

Cancer

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Background Long‐term survivors of non‐Hodgkin lymphoma (NHL) must cope with treatment complications and late toxicities that affect their health‐related quality of life. Little is known about the risk‐to‐benefit ratio of new agents like rituximab. The impact of treatment regimens and health disorders on long‐term fatigue levels was investigated in a cross‐sectional study. Methods Two self‐administered questionnaires, the 20‐item Multidimensional Fatigue Inventory (MFI‐20) and a Life Situation Questionnaire, were mailed in 2015 to NHL survivors enrolled onto 12 successive clinical studies (1993‐2010) conducted by the Lymphoma Study Association. Private addresses were obtained for 3317 survivors, of whom 1671 (50%) returned the questionnaires. Severe fatigue was defined as MFI‐20 scores ≥60 on dimension scales scored from 0 to 100. Linear regression models were used to assess factors that were linked to increased fatigue levels. Results The study population included 906 men and 765 women, and the median age was 64 years (age range, 24‐95 years). Overall, 811 survivors had received cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)‐like chemotherapy, 518 had received high‐dose CHOP, and 342 had undergone upfront autologous stem cell transplantation; 829 survivors also had received rituximab. In total, 1100 survivors (66%) reported 1 or more late health disorders. Severe fatigue was reported by 602 survivors (37%). Increased fatigue levels were associated (P < .001) with increased age, obesity, and the presence of health disorders, but not with initial treatment or rituximab. Conclusions The survey confirms that high proportions long‐term NHL survivors have severe fatigue. The results suggest that initial treatment and the receipt of rituximab have no influence on the development of long‐term fatigue.

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“…In this trial, the 2‐year PFS was 69% and 56% in the experimental arm compared with the standard one ( P = .05), while no significant difference was documented in the 2‐year OS . The phase III FIL‐DLCL04 trial compared two rituximab dose‐dense treatments (R‐CHOP14 versus R‐megaCHOP14) followed or not by BEAM with ASCT . After a follow‐up of 72 months, the 2‐year PFS was 71% in the transplantation group vs 62% in the no transplantation group.…”

Section: Introductionmentioning

confidence: 86%

Frontline treatment of diffuse large B‐cell lymphoma: Beyond R‐CHOP

Mondello

Mian

2019

Hematological Oncology

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Although the majority of patients with diffuse large B‐cell lymphoma (DLBCL) can be cured with the standard immunochemotherapy R‐CHOP, one‐third of them relapses with a dismal outcome in most cases. In the recent years, remarkable advances have been achieved based on the discovery of molecular genetics in DLBCL. In addition to the major cell‐of‐origin designations of germinal center B‐cell and activated B‐cell subtypes, next‐generation sequencing has unveiled the remarkable complexity of DLBCL and identified potential molecular targets for tailored therapies. Despite these findings, the current standard of care for DLBCL patients is still R‐CHOP, and optimization of frontline therapy remains an important goal. In this review, we summarize recent updates on the evolution of frontline therapies for DLBCL.

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Rituximab-dose-dense chemotherapy with or without high-dose chemotherapy plus autologous stem-cell transplantation in high-risk diffuse large B-cell lymphoma (DLCL04): final results of a multicentre, open-label, randomised, controlled, phase 3 study

Cited by 110 publications

References 29 publications

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma

Long‐term fatigue in survivors of non‐Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross‐sectional study

Frontline treatment of diffuse large B‐cell lymphoma: Beyond R‐CHOP

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