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Combination therapy with rituximab may benefit elderly patients with DLBCL
In elderly patients with diffuse large B-cell lymphoma, a combination therapy regimen that includes rituximab appears to yield successful response rates, according to recent study findings published in Thyroid.
In the study, researchers retrospectively reviewed treatment outcomes of 56 patients aged at least 60 years (median, 71 years; range, 60-80 years) diagnosed with diffuse large B-cell lymphoma (DLBCL) at Ito Hospital in Tokyo. Of the 43 patients who qualified for study, 12 had stage IE disease, and 31 had stage IIE aggressive DLBCL. The patients were scheduled to receive combination modality therapy (CMT) including rituximab (Rituxan, Genentech/Biogen Idec) at Ito Hospital or JR Tokyo General Hospital.
CMT generally included radiation therapy and three courses of R-CHOP (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m2 and prednisolone 100 mg/body)-based chemotherapy. As premedication for rituximab, the investigators administered 400 mg acetaminophen and 30 mg diphenhydramine. The patients’ treatment outcomes were retrospectively reviewed.
The researchers defined treatment response as a decrease of at least 50% in the largest diameter of all measurable lesions.
In three patients, radiation could not be performed after R-CHOP; these patients underwent chemotherapy only. Two of these patients developed interstitial pneumonia after R-CHOP, and one patient demonstrated rapid tumor growth on day 16 of R-CHOP course 2, which was determined to be disease progression. Of the 43 patients, 42 had a successful response to treatment (98%). The 5-year overall survival rate was 87% (95% CI, 64-96) and the event-free survival rate was 74% (95% CI, 50-89).
Adverse events included the two cases of interstitial pneumonia as well as the death of one patient. The researchers said the overall findings are encouraging, but additional studies are needed.
“This study demonstrates the utility of the treatment strategy of adding rituximab to CMT chemotherapy in elderly primary thyroid lymphoma patients,” the researchers wrote. “Confirmation of the utility of this treatment in a future multicenter study with longer follow-up and further refinement of treatment strategies to obtain better antitumor effects are desired.”
Disclosure: The researchers report no relevant financial disclosures.