CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma
Open accessAbstract
BACKGROUND: The standard treatment for patients with diffuse large-B-cell lymphoma is cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Rituximab, a chimeric monoclonal antibody against the CD20 B-cell antigen, has therapeutic activity in diffuse large-B-cell lymphoma. We conducted a randomized trial to compare CHOP chemotherapy plus rituximab with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. METHODS: Previously untreated patients with diffuse large-B-cell lymphoma, 60 to 80 years old, were randomly assigned to receive either eight cycles of CHOP every three weeks (197 patients) or eight cycles of CHOP plus rituximab given on day 1 of each cycle (202 patients). RESULTS: The rate of complete response was significantly higher in the group that received CHOP plus rituximab than in the group that received CHOP alone (76 percent vs. 63 percent, P=0.005). With a median follow-up of two years, event-free and overall survival times were significantly higher in the CHOP-plus-rituximab group (P<0.001 and P=0.007, respectively). The addition of rituximab to standard CHOP chemotherapy significantly reduced the risk of treatment failure and death (risk ratios, 0.58 [95 percent confidence interval, 0.44 to 0.77] and 0.64 [0.45 to 0.89], respectively). Clinically relevant toxicity was not significantly greater with CHOP plus rituximab. CONCLUSIONS: The addition of rituximab to the CHOP regimen increases the complete-response rate and prolongs event-free and overall survival in elderly patients with diffuse large-B-cell lymphoma, without a clinically significant increase in toxicity.
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In humans, a reversible depletion of normal B cells is a well-tolerated side effect of the anti-CD20 antibody rituximab, which is an efficacious therapy in mature B cell neoplasms and in autoimmune disease.
“In humans, a reversible depletion of normal B cells is a well-tolerated side effect of the anti-CD20 antibody rituximab, which is an efficacious therapy in mature B cell neoplasms and in autoimmune disease”
From The transcriptional cofactor TRIM33 prevents apoptosis in B lymphoblastic leukemia by deactivating a single enhancer (2015) · cites this paper as Coiffier et al., 2002
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“In humans, a reversible depletion of normal B cells is a well-tolerated side effect of the anti-CD20 antibody rituximab, which is an efficacious therapy in mature B cell neoplasms and in autoimmune disease (Coiffier et al., 2002; Edwards et al., 2004).”
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- Authors
- Coiffier, B., Lepage, E., Brière, J., Herbrecht, R., Tilly, H., Bouabdallah, R., Morel, P., Van Den Neste, E., Salles, G., Gaulard, P., Reyes, F., Lederlin, P., & Gisselbrecht, C.
- Affiliations
- Hospices Civils de Lyon (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hôpital d'Hautepierre (FR)
- Centre Henri Becquerel (FR)
- Centre Hospitalier de Lens (FR)
- Hôpitaux Universitaires Henri-Mondor (FR)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2002-01-24
- Volume
- 346
- Issue
- 4
- Pages
- 235-242
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2058015212
- Cited by
- 5,574
- References
- 26
- Citations by year
- 2026: 156 · 2025: 203 · 2024: 201 · 2023: 197 · 2022: 243 · 2021: 234 · 2020: 233 · 2019: 196 · 2018: 194 · 2017: 235 · 2016: 244 · 2015: 267 · 2014: 258 · 2013: 258 · 2012: 252
- FWCI
- 135.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Neurology › CNS Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
- Keywords
- diffuse large B-cell lymphoma, rituximab, CHOP chemotherapy, elderly patients, anti-CD20 monoclonal antibody, complete response, event-free survival, overall survival, treatment toxicity, combination chemotherapy
- MeSH terms
- Rituximab, Aged, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Cyclophosphamide, Doxorubicin, Female, Humans, Male, Middle Aged, Prednisone, Recurrence, Vincristine, Survival Analysis, Lymphoma, B-Cell, Lymphoma, Large B-Cell, Diffuse, Disease-Free Survival, Antibodies, Monoclonal, Murine-Derived
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