Annals of Oncology 15:1086-1090, 2004
© 2004 European Society for Medical Oncology
Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) for treatment of early-stage gastric diffuse large B-cell lymphoma
Background: Diffuse large B-cell lymphoma (DLBCL) of the stomach is a relatively common disease. Recently, chemotherapy consisting of doxorubicin, cyclophosphamide, vincristine and prednisone (CHOP) has been reported as effective treatment for early-stage gastric DLBCL. Given the fact that the application of the CD20 antibody rituximab (R) in addition to CHOP has improved outcomes in nodal DLBCL, we have analysed our experience with application of R-CHOP in patients with early-stage gastric DLBCL.Patients and methods: Patients with histologically verified early-stage gastric DLBCL undergoing treatment with R-CHOP for initial management were analysed.
Results: Fifteen patients received a total of 79 cycles, with a median of six cycles per patient. All patients responded to therapy, 13 had a complete remission (CR) (87%) and two (13%) a partial remission. All patients in CR, except one who died unrelated to lymphoma, have remained so with a median follow-up of 15 months (range 4–42) after treatment. Subjective tolerance was moderate, and toxicities were mainly haematological, including leukocytopenia WHO grade 3 and 4 in 10 and five patients each. The addition of rituximab to the standard CHOP regimen did not appear to significantly increase toxicity.
Conclusions: Our data indicate that R-CHOP is an effective regimen for management of early-stage gastric DLBCL. However, given the excellent results with CHOP alone in such patients, the value of adding rituximab to standard CHOP remains to be determined in a randomised trial.
Departments of 1 Internal Medicine I, Division of Oncology and Center of Excellence in Clinical and Experimental Oncology (CLEXO); 2 Internal Medicine IV; 3 Clinical Pathology, University of Vienna, Vienna, Austria
*Correspondence to: Dr M. Raderer, Department of Internal Medicine I, Division of Oncology, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria. Tel/Fax: +43-1-40400-2296; Email: markus.raderer{at}akh-wien.ac.at
Key words: chemotherapy, diffuse large B-cell lymphoma, gastric lymphoma, rituximab
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