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rituximab Plus CHOP Vs CHOP in non Hodgkin lymphoma

Patrizia Mondello, Normann Steiner, Wolfgang Willenbacher, Ines Wasle, Francesco Zaja, Renato Zambello, Andrea Visentin, Endri Mauro, Simone Ferrero, Paola Ghione, Vincenzo Pitini, Salvatore Cuzzocrea, Michael Mian
The optimal first-line treatment for advanced low-grade non-Hodgkin lymphomas (LG-NHL) is still highly debated. Recently, the StiL and the BRIGHT trials showed that the combination of rituximab and bendamustine (R-B) is non-inferior to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with a better toxicity profile. Utilizing a retrospective analysis, we compared the efficacy and safety of both regimens in clinical practice. From November 1995 to January 2014, 263 LG-NHL patients treated with either R-B or R-CHOP were retrospectively assessed in seven European cancer centers...
June 2016: Annals of Hematology
Ramesh B V Nimmagadda, Raghunadharao Digumarti, Reena Nair, Dinesh Bhurani, Vinod Raina, Shyam Aggarwal, Shekhar Patil, Pabitra K Gogoi, Subramanian Sundaram, Chanchal Goswami, Shashikant Apte, Srinivas Chakravarthy, Anand Pathak
CONTEXT: The distribution of various subtypes of lymphomas in India is different from other parts of the world. There is scarce multicentric data on the pattern and outcomes of lymphomas in India. AIMS: The aim of this study is to evaluate the histopathological and the clinical pattern and treatment outcomes of lymphomas in India based on the retrospective data collected from a multicenter registry. MATERIALS AND METHODS: Retrospective data was collected at 13 public and private hospitals in India for patients diagnosed with lymphoma between January 2005 and December 2009...
October 2013: Indian Journal of Medical and Paediatric Oncology
Ian W Flinn, Richard van der Jagt, Brad S Kahl, Peter Wood, Tim E Hawkins, David Macdonald, Mark Hertzberg, Yiu-Lam Kwan, David Simpson, Michael Craig, Kathryn Kolibaba, Samar Issa, Regina Clementi, Doreen M Hallman, Mihaela Munteanu, Ling Chen, John M Burke
This randomized, noninferiority (NI), global, phase 3 study evaluated the efficacy and safety of bendamustine plus rituximab (BR) vs a standard rituximab-chemotherapy regimen (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone [R-CHOP] or rituximab plus cyclophosphamide, vincristine, and prednisone [R-CVP]) for treatment-naive patients with indolent non-Hodgkin's lymphoma or mantle cell lymphoma. Investigators preassigned the standard treatment regimen they considered most appropriate for each patient; patients were randomized to receive BR (n = 224) or standard therapy (R-CHOP/R-CVP, n = 223) for 6 cycles; 2 additional cycles were permitted at investigator discretion...
May 8, 2014: Blood
Patrick J Stiff, Joseph M Unger, James R Cook, Louis S Constine, Stephen Couban, Douglas A Stewart, Thomas C Shea, Pierluigi Porcu, Jane N Winter, Brad S Kahl, Thomas P Miller, Raymond R Tubbs, Deborah Marcellus, Jonathan W Friedberg, Kevin P Barton, Glenn M Mills, Michael LeBlanc, Lisa M Rimsza, Stephen J Forman, Richard I Fisher
BACKGROUND: The efficacy of autologous stem-cell transplantation during the first remission in patients with diffuse, aggressive non-Hodgkin's lymphoma classified as high-intermediate risk or high risk on the International Prognostic Index remains controversial and is untested in the rituximab era. METHODS: We treated 397 patients who had disease with an age-adjusted classification of high risk or high-intermediate risk with five cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP plus rituximab...
October 31, 2013: New England Journal of Medicine
Gregory Hill, Richard Barron, Kelly Fust, Michelle E Skornicki, Douglas C A Taylor, Milton C Weinstein, Gary H Lyman
OBJECTIVE: Evaluate the cost-effectiveness of primary vs secondary prophylaxis (PP vs SP) with pegfilgrastim to reduce the risk of febrile neutropenia (FN) in Non-Hodgkin's Lymphoma (NHL) patients receiving myelosuppressive chemotherapy from a US payer perspective. METHODS: A Markov model was used to compare PP vs SP with pegfilgrastim in a cohort of patients receiving six cycles of cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) or CHOP plus rituximab (CHOP-R) chemotherapy...
January 2014: Journal of Medical Economics
David Cunningham, Eliza A Hawkes, Andrew Jack, Wendi Qian, Paul Smith, Paul Mouncey, Christopher Pocock, Kirit M Ardeshna, John A Radford, Andrew McMillan, John Davies, Deborah Turner, Anton Kruger, Peter Johnson, Joanna Gambell, David Linch
BACKGROUND: Dose intensification with a combination of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) every 2 weeks improves outcomes in patients older than 60 years with diffuse large B-cell lymphoma compared with CHOP every 3 weeks. We investigated whether this survival benefit from dose intensification persists in the presence of rituximab (R-CHOP) in all age groups. METHODS: Patients (aged ≥18 years) with previously untreated bulky stage IA to stage IV diffuse large B-cell lymphoma in 119 centres in the UK were randomly assigned centrally in a one-to-one ratio, using minimisation, to receive six cycles of R-CHOP every 14 days plus two cycles of rituximab (R-CHOP-14) or eight cycles of R-CHOP every 21 days (R-CHOP-21)...
May 25, 2013: Lancet
Tark Kim, Sang-Ho Choi, Sung-Han Kim, Jin-Yong Jeong, Jun Hee Woo, Yang Soo Kim, Heungsup Sung, Mi-Na Kim, Dok Hyun Yoon, Cheolwon Suh, Sang-Oh Lee
R-CHOP chemotherapy composed of rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone which might increase the risk of Pneumocystis pneumonia in patients with non-Hodgkin lymphoma. We estimated the point prevalence of Pneumocystis pneumonia in non-Hodgkin lymphoma patients according to the number of R-CHOP cycles and investigated whether cytoreduction by chemotherapy is associated with Pneumocystis pneumonia development. We retrospectively established a cohort of patients who received R-CHOP for non-Hodgkin lymphoma in our institution...
January 2013: Annals of Hematology
Julia Horn, Martina Kleber, Stefanie Hieke, Annette Schmitt-Gräff, Ralph Wäsch, Monika Engelhardt
We analyzed the safety and efficacy of rituximab plus bendamustine (R-B) in elderly and frail patients with aggressive B-non-Hodgkin lymphoma (a-B-NHL). Few reports have as yet reported on R-B in a-B-NHL, albeit its value for indolent lymphoma vs. R-CHOP has impressively been shown. We assessed 20 consecutive patients with a-B-NHL receiving R-B as first-line or relapse treatment after (R)-CHOP in our department. Besides patient- and lymphoma-specific characteristics, comorbidity indices were determined. The median patient age was 72 years (51-86), the median Karnofsky performance status was 55 % (40-90 %), and according to the international prognostic index, 15 had high-intermediate or high-risk disease...
October 2012: Annals of Hematology
Zhi-Tao Ying, Wen Zheng, Xiao-Pei Wang, Yan Xie, Mei-Feng Tu, Ning-Jing Lin, Ling-Yan Ping, Wei-Ping Liu, Li-Juan Deng, Chen Zhang, Jun Zhu, Yu-Qin Song
Mantle cell lymphoma(MCL), a special type of non-Hodgkin's lymphoma, is incurable through conventional treatment. This study aimed to analyze the clinical features, therapeutic responses, and prognosis of patients with MCL. Clinical data of 30 patients with MCL treated in our hospital between April 2006 and July 2011 were analyzed. Eighteen patients were treated with CHOP plus rituximab (R-CHOP) regimen, 12 underwent conventional chemotherapy. The median age of the 30 patients was 58 years, 23 were men, all patients had Cyclin D1 overexpression, 29 (96...
July 2012: Chinese Journal of Cancer
Stefan K Barta, Jeannette Y Lee, Lawrence D Kaplan, Ariela Noy, Joseph A Sparano
BACKGROUND: Improved outcomes have recently been reported for rituximab (R) plus rituximab plus infusional etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH) chemotherapy in patients with human immunodeficiency virus (HIV)-associated, aggressive B-cell, non-Hodgkin lymphoma (NHL). The objective of the current analysis was to assess whether patient selection or other factors contributed to this improvement and to identify patients who are at the greatest risk for lethal toxicity...
August 15, 2012: Cancer
Tanin Intragumtornchai, Udomsak Bunworasate, Thanyaphong Na Nakorn, Ponlapat Rojnuckarin
With currently available combination chemotherapy regimens, the outcome of the patients newly diagnosed with aggressive non-Hodgkin's lymphoma (NHL) identified as 'high' and 'high-intermediate' risk groups according to the international prognostic index (IPI) is still unsatisfactory and a more innovative therapy is urgently required to improve the survival of the patients. The purpose of this study was to compare the efficacy of rituximab given in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and ESHAP (etoposide, methylprednisolone, high-dose Ara-C, cisplatin) vs CHOP-ESHAP and upfront high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) vs standard CHOP in patients aged < or = 65 years old newly diagnosed with 'high' and 'high-intermediate' risk aggressive lymphoma enrolled onto two consecutive treatment trials at the institute...
July 2006: Leukemia & Lymphoma
Latha Shivakumar, James O Armitage
Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma with a 5-year survival rate of 35%-60%. Various clinical factors included in the International Prognostic Index have failed to identify the patients with DLBCL who will not benefit from the standard R-CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone plus rituximab) treatment regimen. Bcl-2 has been implicated in conferring resistance to chemotherapy in non-Hodgkin's lymphoma and is therefore a candidate prognostic marker in DLBCL. To identify the correlation between Bcl-2 expression and response to rituximab-containing treatment regimens, histologic materials were analyzed from 292 elderly patients with confirmed DLBCL...
May 2006: Clinical Lymphoma & Myeloma
Michael Pfreundschuh, Lorenz Trümper, Anders Osterborg, Ruth Pettengell, Marek Trneny, Kevin Imrie, David Ma, Devinder Gill, Jan Walewski, Pier-Luigi Zinzani, Rolf Stahel, Stein Kvaloy, Ofer Shpilberg, Ulrich Jaeger, Mads Hansen, Tuula Lehtinen, Armando López-Guillermo, Claudia Corrado, Adriana Scheliga, Noel Milpied, Myriam Mendila, Michelle Rashford, Evelyn Kuhnt, Markus Loeffler
BACKGROUND: The role of rituximab in combination with different CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like chemotherapy regimens in young patients with good-prognosis diffuse large-B-cell lymphoma remains to be defined. We aimed to compare CHOP-like chemotherapy and rituximab with CHOP-like chemotherapy alone in these patients. METHODS: 824 patients who were from 18 countries; aged 18-60 years; and who had no risk factors or one risk factor according to age-adjusted International Prognostic Index (IPI), stage II-IV disease, or stage I disease with bulk were enrolled...
May 2006: Lancet Oncology
Y H Park, J J Lee, M H Ryu, S Y Kim, D H Kim, Y R Do, K H Lee, S J Oh, Y K Kim, C W Suh, D S Heo, B Y Ryoo, J K Kim, H S Song, W S Lee, H J Kim, Y J Bang, S H Yang, S K Sohn, Y K Kang et al.
The addition of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) has been shown to improve the outcome in all age groups with newly diagnosed diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis to evaluate the impact of this combination therapy on DLBCL outcomes in Korea. From October 2001 to June 2004, newly diagnosed DLBCL patients in nine Korean institutes were included. All of these 81 patients were treated with three or more cycles of rituximab plus CHOP (R-CHOP) combination chemotherapy (R group), and followed for a minimum of 12 months...
April 2006: Annals of Hematology
Greg L Plosker, David P Figgitt
UNLABELLED: Rituximab is an anti-CD20 monoclonal antibody that has demonstrated efficacy in patients with various lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin's lymphoma (NHL) and B-cell chronic lymphocytic leukaemia (CLL). While the optimal use of the drug in many clinical settings has yet to be clarified, two pivotal trials have established rituximab as a viable treatment option in patients with relapsed or refractory indolent NHL, and as a standard first-line treatment option when combined with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy in elderly patients with diffuse large B-cell lymphoma (the most common type of aggressive NHL)...
2003: Drugs
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