Impact of relative dose intensity (RDI) in CHOP combined with rituximab (R-CHOP) on survival in diffuse large B-cell lymphoma

• Main Authors: Koh Ki-Ryang, Ohsawa Masahiko, Takeoka Yasunobu, Nakane Takahiko, Koh Hideo, Inoue Eri, Aimoto Mizuki, Sakamoto Erina, Kanashima Hiroshi, Aimoto Ran, Nakamae Hirohisa, Terada Yoshiki, Yamane Takahisa, Nakao Yoshitaka, Ohta Kensuke, Mugitani Atsuko, Teshima Hirofumi, Hino Masayuki
• Format: Article
• Language: English
• Published: BMC 2009-08-01
• Series: Journal of Experimental & Clinical Cancer Research
• Online Access: http://www.jeccr.com/content/28/1/116

<p>Abstract</p> <p>Background</p> <p>Recently, maintaining higher relative dose intensity (RDI) of chemotherapeutic drugs has become a widespread practice in an attempt to achieve better outcomes in the treatment of aggressive lymphoma. The addition of rituximab to chemotherapy regimens has significantly improved outcome in diffuse large B-cell lymphoma (DLBL). However, it is unknown if higher RDI in chemotherapy when combined with rituximab leads to a better outcome in aggressive B-cell lymphoma.</p> <p>Methods</p> <p>We retrospectively evaluated the impact of the RDI of initial chemotherapy (consisting of cyclophosphamide, doxorubicin, vincristine and prednisolone with rituximab (R-CHOP) on outcome in 100 newly diagnosed DLBL patients.</p> <p>Results</p> <p>A multivariate Cox regression model showed that RDI trended towards a significant association with mortality [hazard ratio per 0.1 of RDI = 0.8; 95% confidence interval 0.6–1.0; <it>P </it>= 0.08]. Additionally, on multivariate logistic analysis, advanced age was a significant factor for reduced RDI.</p> <p>Conclusion</p> <p>Our data suggest that in DLBL patients, mortality was affected by RDI of R-CHOP as the initial treatment, and the retention of a high RDI could therefore be crucial.</p>