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Originally published as JCO Early Release 10.1200/JCO.2005.09.131 on May 2 2005

Journal of Clinical Oncology, Vol 23, No 18 (June 20), 2005: pp. 4117-4126
© 2005 American Society of Clinical Oncology.

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Long-Term Results of the R-CHOP Study in the Treatment of Elderly Patients With Diffuse Large B-Cell Lymphoma: A Study by the Groupe d'Etude des Lymphomes de l'Adulte

P. Feugier, A. Van Hoof, C. Sebban, P. Solal-Celigny, R. Bouabdallah, C. Fermé, B. Christian, E. Lepage, H. Tilly, F. Morschhauser, P. Gaulard, G. Salles, A. Bosly, C. Gisselbrecht, F. Reyes, B. Coiffier

From the Centre Hospitalier Universitaire (CHU) de Brabois, Vandoeuvre les Nancy; Centre Leon Bérard, Lyon; Centre Jean Bernard, Le Mans; Institut Paoli Calmette, Marseille; Institut Gustave Roussy, Villejuif; Hôpital Bon Secours, Metz; CHU Henri Mondor, Créteil; Centre Becquerel, Rouen; CHU de Lille, Lille; Hospices Civils de Lyon, Pierre-Bénite; Hôpital Saint-Louis, Paris, France; Université Catholique de Louvain, Yvoir; and Academisch Ziekenhuis Sint-Jan, Bruges, Belgium

Address reprint requests to Pierre Feugier, MD, Hematology Department, CHU de Brabois, 54500 Vandoeuvre les Nancy, France; e-mail: p.feugier{at}chu-nancy.fr

PURPOSE: To analyze the long-term outcome of patients included in the Lymphome Non Hodgkinien study 98-5 (LNH98-5) comparing cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) to rituximab plus CHOP (R-CHOP) in elderly patients with diffuse large B-cell lymphoma.

PATIENTS AND METHODS: LNH98-5 was a randomized study that included 399 previously untreated patients, age 60 to 80 years, with diffuse large B-cell lymphoma. Patients received eight cycles of classical CHOP (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m2, and prednisone 40 mg/m2 for 5 days) every 3 weeks. In R-CHOP, rituximab 375 mg/m2 was administered the same day as CHOP. Survivals were analyzed using the intent-to-treat principle.

RESULTS: Median follow-up is 5 years at present. Event-free survival, progression-free survival, disease-free survival, and overall survival remain statistically significant in favor of the combination of R-CHOP (P = .00002, P < .00001, P < .00031, and P < .0073, respectively, in the log-rank test). Patients with low-risk or high-risk lymphoma according to the age-adjusted International Prognostic Index have longer survivals if treated with the combination. No long-term toxicity appeared to be associated with the R-CHOP combination.

CONCLUSION: Using the combination of R-CHOP leads to significant improvement of the outcome of elderly patients with diffuse large B-cell lymphoma, with significant survival benefit maintained during a 5-year follow-up. This combination should become the standard for treating these patients.

Authors' disclosures of potential conflicts of interest are found at the end of this article.


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Copyright © 2005 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
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