JOURNAL ARTICLE

The effect of adding rituximab to CHOP-based therapy on clinical outcomes for Japanese patients with diffuse large B-cell lymphoma: a propensity score matching analysis

Hisakazu Nishimori, Keitaro Matsuo, Yoshinobu Maeda, Yuichiro Nawa, Kazutaka Sunami, Kazuto Togitani, Hidetaka Takimoto, Yasushi Hiramatsu, Toru Kiguchi, Tomofumi Yano, Hiromichi Yamane, Takayuki Tabayashi, Makoto Takeuchi, Masanori Makita, Nobuo Sezaki, Yoshiko Yamasuji, Haruko Sugiyama, Takahiro Tabuchi, Itaru Kataoka, Nobuharu Fujii, Fumihiko Ishimaru, Katsuji Shinagawa, Kazuma Ikeda, Masamichi Hara, Tadashi Yoshino, Mitsune Tanimoto
International Journal of Hematology 2009, 89 (3): 326-331
19326060
We conducted a retrospective analysis to evaluate the impact on clinical outcomes of adding rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) treatment for diffuse large B-cell lymphoma (DLBCL) patients in Japan. A propensity score method was used to compensate for the non-randomized study design. From January 2000 to December 2004, 378 patients who were newly diagnosed with DLBCL at 13 institutes were enrolled: 123 in the rituximab plus CHOP-based chemotherapy (R+) group, and 255 in the CHOP-based chemotherapy only (R-) group. The complete response rate was significantly higher in the R+ group than in the R- group (77.7 vs. 69.4%, P < 0.001). The progression-free survival (PFS) at 2 years was 62.4% in the R+ group and 57.0% in the R- group. The 2-year overall survival (OS) was 76.9% for the R+ group and 70.5% for the R- group. A multivariate analysis revealed that the addition of rituximab was a strong independent prognostic factor for PFS (hazard ratio 0.64, 95% CI 0.43-0.96, P = 0.031). A subgroup analysis revealed that R+ particularly benefited younger patients (hazard ratio 0.25, 95% CI 0.08-0.75, P = 0.013). IPI also showed significant impact for PFS (hazard ratio 1.82, 95% CI 1.55-2.14 for one score increase, P < 0.001) as well as OS (hazard ratio 2.10, 95% CI 1.71-2.57, P < 0.001). In summary, the addition of rituximab to CHOP-based chemotherapy results in better outcomes for Japanese DLBCL patients, particularly younger patients.

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