Immunochemotherapy With Rituximab and Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone Significantly Improves Response and Time to Treatment Failure, But Not Long-Term Outcome in Patients With Previously Untreated Mantle Cell Lymphoma: Results of a Prospective Randomized Trial of the German Low Grade Lymphoma Study Group (GLSG)
-
Published:2005-03-20
Issue:9
Volume:23
Page:1984-1992
-
ISSN:0732-183X
-
Container-title:Journal of Clinical Oncology
-
language:en
-
Short-container-title:JCO
Author:
Lenz Georg1, Dreyling Martin1, Hoster Eva1, Wörmann Bernhard1, Dührsen Ulrich1, Metzner Bernd1, Eimermacher Hartmut1, Neubauer Andreas1, Wandt Hannes1, Steinhauer Hjalmar1, Martin Sonja1, Heidemann Else1, Aldaoud Ali1, Parwaresch Reza1, Hasford Joerg1, Unterhalt Michael1, Hiddemann Wolfgang1
Affiliation:
1. From the Department of Internal Medicine III, Ludwig-Maximilians University; Department of Medical Informatics, Biometrics and Epidemiology (IBE), Ludwig-Maximilians University, Munich; Department of Internal Medicine II, Städtisches Klinikum Braunschweig, Braunschweig; Department of Hematology, University of Essen, Essen; Department of Internal Medicine II, Klinikum Oldenburg, Oldenburg; Department of Hematology and Oncology, Katholisches Krankenhaus, Hagen, Hagen; Department of Hematology and Oncology,...
Abstract
Purpose Mantle cell lymphoma (MCL) is characterized by a poor prognosis with a low to moderate sensitivity to chemotherapy and a median survival of only 3 to 4 years. In an attempt to improve outcome, the German Low Grade Lymphoma Study Group (GLSG) initiated a randomized trial comparing the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and rituximab (R-CHOP) with CHOP alone as first-line therapy for advanced-stage MCL. Patients and Methods One hundred twenty-two previously untreated patients with advanced-stage MCL were randomly assigned to six cycles of CHOP (n = 60) or R-CHOP (n = 62). Patients up to 65 years of age achieving a partial or complete remission underwent a second randomization to either myeloablative radiochemotherapy followed by autologous stem-cell transplantation or interferon alfa maintenance (IFNα). All patients older than 65 years received IFNα maintenance. Results R-CHOP was significantly superior to CHOP in terms of overall response rate (94% v 75%; P = .0054), complete remission rate (34% v 7%; P = .00024), and time to treatment failure (TTF; median, 21 v 14 months; P = .0131). No differences were observed for progression-free survival. Toxicity was acceptable, with no major differences between the two therapeutic groups. Conclusion The combined immunochemotherapy with R-CHOP resulted in a significantly higher response rate and a prolongation of the TTF as compared with chemotherapy alone. Hence, R-CHOP may serve as a new baseline regimen for advanced stage MCL, but needs to be further improved by novel strategies in remission.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Reference38 articles.
1. Jaffe ES, Harris NL, Stein H, et al: World Health Organization Classification of Tumours: Tumours of the Haemopoitic and Lymphoid Tissues . IARC Press, Lyon, France, 2001 2. Meusers P, Hense J, Brittinger G: Mantle cell lymphoma: Diagnostic criteria, clinical aspects and therapeutic problems. Leukemia 11:S60,1997-S64, (suppl 2) 3. Mantle cell lymphoma-- an entity comes of age 4. Hiddemann W, Dreyling MH, Tiemann M, et al: Mantle cell lymphomas. Haematologica 84:93,1999-95, 5. Mantle cell lymphoma. A clinicopathologic study of 68 cases from the Nebraska Lymphoma Study Group
Cited by
505 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|