Six versus eight doses of rituximab in patients with aggressive B cell lymphoma receiving six cycles of CHOP: results from ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-01-04

AUTHORS

Andreas Hüttmann, Jan Rekowski, Stefan P. Müller, Bernd Hertenstein, Christiane Franzius, Rolf Mesters, Matthias Weckesser, Frank Kroschinsky, Jörg Kotzerke, Arnold Ganser, Frank M. Bengel, Paul La Rosée, Martin Freesmeyer, Heinz-Gert Höffkes, Andreas Hertel, Dirk Behringer, Gabriele Prange-Krex, Martin Griesshammer, Jens Holzinger, Stefan Wilop, Thomas Krohn, Aruna Raghavachar, Georg Maschmeyer, Ingo Brink, Roland Schroers, Tobias Gaska, Helga Bernhard, Aristoteles Giagounidis, Jochen Schütte, Ariane Dienst, Hubertus Hautzel, Ralph Naumann, Alfred Klein, Dennis Hahn, Gabriele Pöpperl, Matthias Grube, Jörg Marienhagen, Andreas Schwarzer, Lars Kurch, Thomas Höhler, Heike Steiniger, Holger Nückel, Thomas Südhoff, Wolfgang Römer, Marcus Brinkmann, Claudia Ose, Ferras Alashkar, Christine Schmitz, Jan Dürig, Dieter Hoelzer, Karl-Heinz Jöckel, Wolfram Klapper, Ulrich Dührsen

ABSTRACT

Standard first-line treatment of aggressive B cell lymphoma comprises six or eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus eight doses of rituximab (R). Whether adding two doses of rituximab to six cycles of R-CHOP is of therapeutic benefit has not been systematically investigated. The Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas (PETAL) trial investigated the ability of [18F]-fluorodesoxyglucose PET scanning to guide treatment in aggressive non-Hodgkin lymphomas. Patients with B cell lymphomas and a negative interim scan received six cycles of R-CHOP with or without two extra doses of rituximab. For reasons related to trial design, only about a third underwent randomization between the two options. Combining randomized and non-randomized patients enabled subgroup analyses for diffuse large B cell lymphoma (DLBCL; n = 544), primary mediastinal B cell lymphoma (PMBCL; n = 37), and follicular lymphoma (FL) grade 3 (n = 35). With a median follow-up of 52 months, increasing the number of rituximab administrations failed to improve outcome. A non-significant trend for improved event-free survival was seen in DLBCL high-risk patients, as defined by the International Prognostic Index, while inferior survival was observed in female patients below the age of 60 years. Long-term outcome in PMBCL was excellent. Differences between FL grade 3a and FL grade 3b were not apparent. The results were confirmed in a Cox proportional hazard regression model and a propensity score matching analysis. In conclusion, adding two doses of rituximab to six cycles of R-CHOP did not improve outcome in patients with aggressive B cell lymphomas and a fast metabolic treatment response. More... »

PAGES

897-907

Journal

TITLE

Annals of Hematology

ISSUE

4

VOLUME

98

Author Affiliations

  • Klinik für Hämatologie, Universitätsklinikum Essen, Essen, Germany
  • Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
  • Klinik für Nuklearmedizin, Universitätsklinikum Essen, Essen, Germany
  • Medizinische Klinik I, Klinikum Bremen-Mitte, Bremen, Germany
  • Zentrum für moderne Diagnostik (Zemodi), Zentrum für Nuklearmedizin und PET/CT, Bremen, Germany
  • Medizinische Klinik A, Universitätsklinikum Münster, Münster, Germany
  • Klinik für Nuklearmedizin, Universitätsklinikum Münster, Münster, Germany
  • Medizinische Klinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
  • Klinik für Nuklearmedizin, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
  • Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany
  • Klinik für Nuklearmedizin, Medizinische Hochschule Hannover, Hannover, Germany
  • Klinik für Innere Medizin II, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Germany
  • Klinik für Nuklearmedizin, Universitätsklinikum Jena, Jena, Germany
  • Tumorklinik, Klinikum Fulda, Fulda, Germany
  • Klinik für Diagnostische und Therapeutische Nuklearmedizin, Klinikum Fulda, Fulda, Germany
  • Klinik für Hämatologie, Onkologie und Palliativmedizin, Augusta-Kranken-Anstalt, Bochum, Germany
  • Onkologische Gemeinschaftspraxis, Dresden, Germany
  • Universitätsklinik für Hämatologie, Onkologie, Gerinnungsstörungen und Palliativmedizin, Johannes Wesling Klinikum, Minden, Germany
  • Institut für Diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Johannes Wesling Klinikum, Minden, Germany
  • Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Universitätsklinikum Aachen, Aachen, Germany
  • Klinik für Nuklearmedizin, Universitätsklinikum Aachen, Aachen, Germany
  • Medizinische Klinik 1, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
  • Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Ernst von Bergmann, Potsdam, Germany
  • Klinik für nuklearmedizinische Diagnostik und Therapie, Ernst von Bergmann Klinikum, Potsdam, Germany
  • Medizinische Klinik, Knappschaftskrankenhaus, Ruhr-Universität Bochum, Bochum, Germany
  • Klinik für Hämatologie und Onkologie, Brüderkrankenhaus St. Josef, Paderborn, Germany
  • Medizinische Klinik V, Klinikum Darmstadt, Darmstadt, Germany
  • Klinik für Onkologie, Hämatologie und Palliativmedizin, Marien Hospital, Düsseldorf, Germany
  • Überörtliche Schwerpunktpraxis für Onkologie, Hämatologie und ambulante Tumortherapie, Düsseldorf, Germany
  • Klinik für Hämatologie, Onkologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
  • Klinik für Nuklearmedizin, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
  • St. Marienkrankhaus, Medizinische Klinik III, Hämatologie, Medizinische Onkologie und Palliativmedizin, Siegen, Germany
  • Klinik für Nuklearmedizin, Bundeswehrkrankenhaus, Koblenz, Germany
  • Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Stuttgart, Stuttgart, Germany
  • Klinik für Nuklearmedizin, Klinikum Stuttgart, Stuttgart, Germany
  • Klinik für Innere Medizin III, Universitätsklinikum Regensburg, Regensburg, Germany
  • Abteilung für Nuklearmedizin, Universitätsklinikum Regensburg, Regensburg, Germany
  • Onkopraxis Probstheida, Leipzig, Germany
  • Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
  • Medizinische Klinik I, Prosper-Hospital, Recklinghausen, Germany
  • Praxis für Hämatologie und Onkologie, Oberhausen, Germany
  • Gemeinschaftspraxis für Hämatologie, Onkologie, Hämostaseologie und Palliativmedizin, Bochum, Germany
  • 2. Medizinische Klinik, Klinikum Passau, Passau, Germany
  • Nuklearmedizinische Gemeinschaftspraxis, Klinikum Passau, Passau, Germany
  • Zentrum für Klinische Studien Essen (ZKSE), Universität Duisburg-Essen, Essen, Germany
  • Onkologikum, Frankfurt/Main, Germany
  • Institut für Pathologie, Sektion für Hämatopathologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00277-018-3578-0

    DOI

    http://dx.doi.org/10.1007/s00277-018-3578-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111099578

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30610279


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