R-CHOP regimen can significantly decrease the risk of disease relapse and progression in patients with non-germinal center B-cell subtype diffuse large B-cell lymphoma

• Published in: Ai zheng Vol. 31; no. 6; pp. 306 - 314
• Main Authors: He, Xiao-Hui, Li, Bo, Yang, Sheng, Lu, Ning, Zhang, Xun, Zou, Shuang-Mei, Li, Ye-Xiong, Song, Yong-Wen, Zheng, Shan, Dong, Mei, Zhou, Sheng-Yu, Yang, Jian-Liang, Liu, Peng, Zhang, Chang-Gong, Qin, Yan, Feng, Feng-Yi, Shi, Yuan-Kai
• Format: Journal Article
• Language: English
• Published: England Department of Medical Oncology,Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P. R. China%Department of Pathology,Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P. R. China%Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P. R. China 01.06.2012; Sun Yat-sen University Cancer Center
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; B细胞淋巴瘤; Cyclophosphamide - therapeutic use; Disease Progression; Disease-Free Survival; Doxorubicin - analogs & derivatives; Doxorubicin - therapeutic use; Female; Follow-Up Studies; Germinal Center - pathology; Humans; Interferon Regulatory Factors - metabolism; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Middle Aged; Neprilysin - metabolism; Original; Prednisone - therapeutic use; Proportional Hazards Models; Proto-Oncogene Proteins c-bcl-2 - metabolism; Proto-Oncogene Proteins c-bcl-6 - metabolism; Recurrence; Retrospective Studies; Rituximab; Survival Rate; Vincristine - therapeutic use; Young Adult; 亚型; 复发; 弥漫性; 患者; 生发; 疾病; 风险; NF-κB; immunohistochemistry; chemotherapy; rituximab; Diffuse large B-cell lymphoma
• ISSN: 1000-467X; 1944-446X
• DOI: 10.5732/cjc.011.10420

To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype （non-GCB） diffuse large B-cell lymphoma （DLBCL）, 159 newly diagnosed DLBCL patients were studied retrospectively based on the immunohistochemical evaluation of CD10, Bcl-6, MUM-l, and Bcl-2. Altogether, 110 patients underwent the CHOP-like regimen, and rituximab was added for the other 49 patients. Cox regression analysis showed that compared with the CHOP-like regimen, the rituximab-based regimen （R-CHOP regimen） significantly decreased the risk of disease relapse and progression in CD10-negative patients （P = 0.001）, Bcl-6-negative patients （P = 0.01）, and MUM-l-positive patients （P = 0.003）. The risk of disease relapse in patients with non-GCB subtype（P = 0.002） also decreased. In contrast, patients with the opposite immunohistochemical marker expression profile and GCB subtype did not benefit from treatment with the R-CHOP regimen. In addition, non-GCB subtype patients had a significantly higher expression rate of Bcl-2 than GCB subtype patients （P = 0.042）. Although univariate analysis found that both Bcl-2-positive and -negative patients had significantly higher event-free survival rates with the R-CHOP regimen, only Bcl-2 positivity （P = 0.004） maintained significance in the Cox regression analysis. We conclude that the addition of rituximab can significantly improve the prognosis of patients with non-GCB subtype DLBCL, which is closely related to the expression of CD10, Bcl-6, MUM-l, and Bcl-2.