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Med Oncol. 2006;23(2):283-93.

Outcome for young high-risk aggressive B-cell lymphoma patients treated with CHOEP-14 and rituximab (R-CHOEP-14).

Author information

1
Department of Oncology, Uppsala University Hospital, 751 85 Uppsala Sweden. Magdalena.Adde@Akademiska.se

Abstract

PURPOSE:

To study the effectiveness and tolerability of a dose-intensified treatment including rituximab for patients, not older than 65 yr, with high-risk aggressive B-cell lymphoma.

PATIENTS:

Thirty-eight patients with high-risk aggressive B-cell lymphoma, the majority classified as grade 2 or 3 using age-adjusted International Prognostic Index, were treated with six courses of CHOEP + rituximab on a 2-wk schedule with G-CSF d 4-11. CNS prophylaxis was administered using intravenous Ara-C as a single dose at the end of treatment.

RESULTS:

All patients were considered responders after three courses. Thirty-one patients (82%) achieved a complete remission or a complete remission unverified. With a median follow up of 27 mo, overall and event-free survival are 79% and 60%, respectively. Treatment was given on an outpatient basis. There were no treatment- related unexpected toxic events or mortalities. Large-cell lymphoma involvement of the bone marrow was a poor prognostic sign even with this intensified treatment and 4/6 patients relapsed. CNS relapse occurred in three patients, two of whom had large cell bone marrow involvement.

CONCLUSION:

Although only a short follow up, the R-CHOEP-14 regimen is promising and could be an improvement compared to conventional treatment, with acceptable toxicity. The value of intravenous Ara-C at the end of treatment can be questioned, as it did not prevent CNS relapse or affect treatment outcome.

PMID:
16720929
DOI:
10.1385/MO:23:2:283
[Indexed for MEDLINE]

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