Originally published as JCO Early Release 10.1200/JCO.2007.15.4278 on May 27 2008

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Retrospective Analysis of Intravascular Large B-Cell Lymphoma Treated With Rituximab-Containing Chemotherapy As Reported by the IVL Study Group in Japan

Kazuyuki Shimada, Kosei Matsue, Kazuhito Yamamoto, Takuhei Murase, Naoaki Ichikawa, Masataka Okamoto, Nozomi Niitsu, Hiroshi Kosugi, Norifumi Tsukamoto, Hiroshi Miwa, Hideki Asaoku, Ako Kikuchi, Morio Matsumoto, Yoshio Saburi, Yasufumi Masaki, Motoko Yamaguchi, Shigeo Nakamura, Tomoki Naoe, Tomohiro Kinoshita

From the Department of Hematology and Oncology, Nagoya University Graduate School of Medicine; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital; Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya; Division of Hematology/Oncology, Kameda General Hospital, Kamogawa; Department of Internal Medicine, Nishio Municipal Hospital, Nishio; First Department of Internal Medicine, Nagano Red Cross Hospital, Nagano; Department of Medicine, Fujita-Health University School of Medicine, Tokyoake; Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka; Department of Hematology, Ogaki Municipal Hospital, Ogaki; Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi; Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute; Internal Medicine, Hiroshima Red Cross Hospital, Hiroshima; Department of Hematology, Tokai University School of Medicine, Isehara; Department of Hematology, Nishigunma National Hospital, Shibukawa; Department of Hematology, Oita Prefectural Hospital, Oita; Department of Hematology and Immunology, Kanazawa Medical University School of Medicine, Uchinada; and Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan

Corresponding author: Tomohiro Kinoshita, MD, Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan; e-mail: kinosita{at}med.nagoya-u.ac.jp

Purpose: To evaluate the safety and efficacy of rituximab-containing chemotherapies for intravascular large B-cell lymphoma (IVLBCL).

Patients and Methods: We retrospectively analyzed 106 patients (59 men, 47 women) with IVLBCL who received chemotherapy either with rituximab (R-chemotherapy, n = 49) or without rituximab (chemotherapy, n = 57) between 1994 and 2007 in Japan. The median patient age was 67 years (range, 34 to 84 years). The International Prognostic Index was high-intermediate/high in 97% of patients.

Results: The complete response rate was higher for patients in the R-chemotherapy group (82%) than for those in the chemotherapy group (51%; P = .001). The median duration of follow-up for surviving patients was 18 months (range, 1 to 95 months). Progression-free survival (PFS) and overall survival (OS) rates at 2 years after diagnosis were significantly higher for patients in the R-chemotherapy group (PFS, 56%; OS, 66%) than for patients in the chemotherapy group (PFS, 27% with P = .001; OS, 46% with P = 0.01). Multivariate analysis revealed that the use of rituximab was favorably associated with PFS (hazard ratio [HR], 0.45; 95% CI, 0.25 to 0.80; P = .006) and OS (HR, 0.42; 95% CI, 0.21 to 0.85; P = .016). Treatment-related death was observed in three patients (6%) who received R-chemotherapy and in five patients (9%) who received chemotherapy.

Conclusion: Our data suggest improved clinical outcomes for patients with IVLBCL in the rituximab era. Future prospective studies of rituximab-containing chemotherapies are warranted.

published online ahead of print at www.jco.org on May 27, 2008.

Supported in part by Grant No. 19-8, a Grant-in-Aid for Cancer Research, from the Ministry of Health, Labour, and Welfare, Tokyo, Japan.

Presented in part at the 49th Annual Meeting of the American Society of Hematology, December 10, 2007, Atlanta, GA.

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