R-CHOP regimen can significantly decrease the risk of disease relapse and progression in patients with non-germinal center B-cell subtype diffuse large B-cell lymphoma.

Abstract

To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype (non-GCB) diffuse large B-cell lymphoma(DLBCL), 159 newly diagnosed DLBCL patients were studied retrospectively based on the immunohistochemical evaluation of CD10, Bcl-6, MUM-1, and Bcl-2. Altogether, 110 patients underwent the CHOP-like regimen, and rituximab was added for the other 49 patients. Cox regression analysis showed that compared with the CHOP-like regimen, the rituximab-based regimen(R-CHOP regimen) significantly decreased the risk of disease relapse and progression in CD10-negative patients (P=0.001), Bcl-6-negative patients (P=0.01), and MUM-1-positive patients (P=0.003). The risk of disease relapse in patients with non-GCB subtype (P=0.002) also decreased. In contrast, patients with the opposite immunohistochemical marker expression profile and GCB subtype did not benefit from treatment with the R-CHOP regimen. In addition, non-GCB subtype patients had a significantly higher expression rate of Bcl-2 than GCB subtype patients (P=0.042). Although univariate analysis found that both Bcl-2-positive and -negative patients had significantly higher event-free survival rates with the R-CHOP regimen, only Bcl-2 positivity (P=0.004) maintained significance in the Cox regression analysis. We conclude that the addition of rituximab can significantly improve the prognosis of patients with non-GCB subtype DLBCL, which is closely related to the expression of CD10, Bcl-6, MUM-1, and Bcl-2.

• Authors: Xiao-Hui He, Bo Li, Sheng Yang, Ning Lu, Xun Zhang, Shuang-Mei Zou, Ye-Xiong Li, Yong-Wen Song, Shan Zheng, Mei Dong, Sheng-Yu Zhou, Jian-Liang Yang, Peng Liu, Chang-Gong Zhang, Yan Qin, Feng-Yi Feng, Yuan-Kai Shi
• Journal: Chinese journal of cancer (Chin J Cancer) Vol. 31 Issue 6 Pg. 306-14 (Jun 2012) ISSN: 1000-467X [Print] England
• PMID: 22640627 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents
• Interferon Regulatory Factors
• Proto-Oncogene Proteins c-bcl-2
• Proto-Oncogene Proteins c-bcl-6
• interferon regulatory factor-4
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Neprilysin
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Murine-Derived (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cyclophosphamide (therapeutic use)
• Disease Progression
• Disease-Free Survival
• Doxorubicin (analogs & derivatives, therapeutic use)
• Female
• Follow-Up Studies
• Germinal Center (pathology)
• Humans
• Interferon Regulatory Factors (metabolism)
• Lymphoma, Large B-Cell, Diffuse (drug therapy, metabolism, pathology)
• Male
• Middle Aged
• Neprilysin (metabolism)
• Prednisone (therapeutic use)
• Proportional Hazards Models
• Proto-Oncogene Proteins c-bcl-2 (metabolism)
• Proto-Oncogene Proteins c-bcl-6 (metabolism)
• Recurrence
• Retrospective Studies
• Rituximab
• Survival Rate
• Vincristine (therapeutic use)
• Young Adult