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Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew

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Biweekly CHOP therapy improves therapeutic effect in the non-GCB subtype of diffuse large B-cell lymphoma

1Department of Medical Oncology, Tumor Hospital of Harbin Medical University, 150040, Harbin, China

© 2007 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. (CC BY-NC-ND 3.0)

Citation Information: Open Medicine. Volume 2, Issue 4, Pages 488–498, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-007-0041-3, December 2007

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CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) is accepted as the best available standard treatment for diffuse large B-cell lymphoma (DLBCL) patients; however, the therapeutic efficacy seems unsatisfactory. Additional rituximab will improve the cure rate, but it is not popular in China because of its increased medical cost. Germinal center B-cell (GCB) and non-GCB subtypes distinction have been described as independent prognostic factors, and provides likelihood for cure with chemotherapy. The aim of the study is to explore the association between Immunophenotype and treatment regimen. Between August 2003 and May 2006, 66 patients with DLBCL were enrolled, according to immunohistochemistry results (GCB and non-GCB phenotype), randomly assigned to receive either six to eight cycles of CHOP every 2 weeks or standard CHOP every 3 weeks. After a median follow-up duration of 32 months (range of 4 to 42 months), an estimated 3-year overall survival (OS) rate for the GCB patients were 68.2% and 55.6% for the biweekly CHOP regimen and standard CHOP regimen respectively, while the data were 62.8% and 37.9% respectively for the non-GCB cases. The biweekly CHOP therapy showed higher efficacy than standard treatment, and its superiority was more obvious with the non-GCB subgroup. All rights reserved.

Keywords: Diffuse large B-cell lymphoma (DLBCL); GCB; non-GCB; CHOP

  • [1] B. Coiffier, E. Lepage and J. Briere: “CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma”, N. Engl. Med., Vol. 346, (2002), pp. 235–242. http://dx.doi.org/10.1056/NEJMoa011795 [Crossref]

  • [2] P. Feugier, A. Van Hoof and C. Sebban: “Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: A study by the Grouped Etude des Lymphomes del Adulte”, J. Clin. Oncol., Vol. 23, (2005), pp. 4117–4126. http://dx.doi.org/10.1200/JCO.2005.09.131 [Crossref]

  • [3] T.M. Habermann, E.A. Weller and V.A. Morrison: “Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma”, J. Clin. Oncol., Vol. 24, (2006), pp. 3121–3127. http://dx.doi.org/10.1200/JCO.2005.05.1003 [Crossref]

  • [4] C.P. Hans, D.D. Weisenburger and T.C. Greiner: “Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray”, Blood, Vol. 103, (2004), pp. 275–282. http://dx.doi.org/10.1182/blood-2003-05-1545 [Crossref]

  • [5] A.A. Alizadeh, M.B. Eisen and R.E. Davis: “Distinct type of diffuse large B-cell lymphoma identified by gene expression profiling”, Nature, Vol. 403, (2000), pp. 503–511. http://dx.doi.org/10.1038/35000501 [Crossref]

  • [6] A.I. Saez, A.J. Saez and M.J. Artiga: “Building an outcome predictor model for diffuse large B-cell lymphoma”, Am. J. Pathol., Vol. 164, (2004), pp. 613–622.

  • [7] A. Dogan, E. Bagdi and P. Munson: “CD10 and BCL-6 expression in paraffin sections of normal lymphoid tissue and B-cell lymphomas”, Am. J. Surg. Pathol., Vol. 24, (2000), pp. 846–852. http://dx.doi.org/10.1097/00000478-200006000-00010 [Crossref]

  • [8] B. Faleni and D.Y. Mason: “Proteins encoded by genes involved in chromosomal alterations in lymphoma and leukemia: clinical value of their detection by immunocytochemistry”, Blood, Vol. 99, (2002), pp. 409–426. http://dx.doi.org/10.1182/blood.V99.2.409 [Crossref]

  • [9] B. Falini, M. Fizzotti and A. Pucciarini: “A monoclonal antibody (MUM1p) detects expression of the MUM1/IRF4 protein in a subset of germinal center B cells, plasma cells, and activated T cells”, Blood, Vol. 95, (2000), pp. 2084–2092.

  • [10] M.M. Oken, R.H. Creech and D.C. Tormey: “Toxicity and response criteria of the Eastern Cooperative Oncology Group”, Am. J. Clin. Oncol., Vol. 5, (1982), pp. 569–573. http://dx.doi.org/10.1097/00000421-198212000-00014 [Crossref]

  • [11] P.P. Carbone, H.S. Kaplan and K. Musshoff: “Report of the committee on Hodgkin’s disease staging classification”, Cancer Res., Vol. 31, (1971), pp. 1860–1861.

  • [12] The international non-Hodgkin’s lymphoma prognostic factors project: “A predictive model for aggressive non-Hodgkin’s lymphoma”, N. Engl. J. Med., Vol. 329, (1993), pp. 987–994. http://dx.doi.org/10.1056/NEJM199309303291402 [Crossref]

  • [13] B.D. Cheson, S.J. Homing and B. Coiffier: “Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphoma”, J. Clin. Oncol., Vol. 17, (1999), pp. 1244–1253.

  • [14] B.H. Ye, P.H. Rao and R.S. Chaganti: “Cloning of bcl-6, the locus involved in chromosome translocations affecting band 3q27 in B-cell lymphoma”, Cancer Res., Vol. 53, (1993), pp. 2732–2735.

  • [15] B. Coiffier: “Increasing chemotherapy intensity in aggressive lymphomas: a renewal?”, J. Clin. Oncol., Vol. 13, (2003), pp. 2457–2459. http://dx.doi.org/10.1200/JCO.2003.93.116 [Crossref]

  • [16] V.A. Morrison, V. Picozzi and S. Scott: “The impact of age on delivered dose intensity and hospitalizations for febrile neutropenia in patients with intermediate-grade non-Hodgkin’ lymphoma receiving initial CHOP chemotherapy: a risk factor analysis”, Clinical Lymphoma, Vol. 2, (2001), pp. 47–56. http://dx.doi.org/10.3816/CLM.2001.n.011 [Crossref]

  • [17] T. Philip, C. Guglielmi and R. Somers: “Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma”, N. Eng. J. Med., Vol. 333, (1995), pp. 1540–1545. http://dx.doi.org/10.1056/NEJM199512073332305 [Crossref]

  • [18] A.M. Gianni, M. Bredni and S. Siena: “High-dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma”, N. Engl. J. Med., Vol. 336, (1997), pp. 1290–1297. http://dx.doi.org/10.1056/NEJM199705013361804 [Crossref]

  • [19] M.A. Shipp, M.D. Abeloff and K.H. Antman: “International consensus conference on high-dose therapy with hematopoietic stem cell transplantation in aggressive non-Hodgkin’s lymphomas: report of the jury”, J. Clin. Oncol., Vol. 17, (1999), pp. 423–429.

  • [20] K. Itoh, T. Ohtsu and H. Fukuda: “Randomized phase II study of biweekly CHOP and dose-escalated CHOP with prophylactic use of lenograstim (glycosylated GCSF) in aggressive non-Hodgkin’s lymphoma: Japan Clinical Oncology Group Study 9505”, Ann. Oncol., Vol 13, (2002), pp. 1347–1355. http://dx.doi.org/10.1093/annonc/mdf287 [Crossref]

  • [21] D.C. Betticher, G. Martinelli and J.A. Radford: “Sequential high dose chemotherapy as initial treatment for aggressive sub-types of non-Hodgkin Lymphoma: results of the international randomized phase III trial (MISTRAL)”, Annals of Oncology, Vol. 17, (2006), pp. 1546–1552. http://dx.doi.org/10.1093/annonc/mdl153 [Crossref]

  • [22] D.W. Blayney, B.W. McGuire and S.E. Cruickshank: “Increasing chemotherapy dose density and intensity: phase I trials in non-small cell lung cancer and non-Hodgkin’s lymphoma”, Oncologist, Vol. 10, (2005), pp. 138–149. http://dx.doi.org/10.1634/theoncologist.10-2-138 [Web of Science] [Crossref]

  • [23] M. Pfreundschuh, L. Trümper and M. Kloess: “Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL”, Blood, Vol. 104, (2004), pp. 626–633. http://dx.doi.org/10.1182/blood-2003-06-2094

  • [24] M. Pfreundschuh, L. Trümper and M. Kloess: “Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the SHNHL”, Blood, Vol. 104, (2004), pp. 634–641. http://dx.doi.org/10.1182/blood-2003-06-2095

  • [25] M. Daliu, Z. Xiaoyan and L. Hongfeng: “BCL 6, CD10 and BCL 2 protein expression in B cell non-Hodgkin’s lymphoma and its clinicopathologic significance”, China oncology, Vol. 16, (2006), pp. 169–173.

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