Journal ArticleDOI
CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group.
Michael Pfreundschuh,Evelyn Kuhnt,Lorenz Trümper,Anders Österborg,Marek Trneny,Lois E. Shepherd,Devinder Gill,Jan Walewski,Ruth Pettengell,Ulrich Jaeger,Pier Luigi Zinzani,Ofer Shpilberg,Stein Kvaløy,Peter de Nully Brown,Rolf A. Stahel,Noel Milpied,Armando López-Guillermo,Viola Poeschel,Sandra Grass,Markus Loeffler,Niels Murawski +20 more
TLDR
Rituximab added to six cycles of CHOP-like chemotherapy improved long-term outcomes for young patients with good-prognosis diffuse large-B-cell lymphoma and the definition of two prognostic subgroups allows a more refined therapeutic approach to these patients than does assessment by IPI alone.Abstract:
Summary Background The MInT study was the first to show improved 3-year outcomes with the addition of rituximab to a CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimen in young patients with good-prognosis diffuse large-B-cell lymphoma. Extended follow-up was needed to establish long-term effects. Methods In the randomised open-label MInT study, patients from 18 countries (aged 18–60 years with none or one risk factor according to the age-adjusted International Prognostic Index [IPI], stage II–IV disease or stage I disease with bulk) were randomly assigned to receive six cycles of a CHOP-like chemotherapy with or without rituximab. Bulky and extranodal sites received additional radiotherapy. Randomisation was done centrally with a computer-based tool and was stratified by centre, bulky disease, age-adjusted IPI, and chemotherapy regimen by use of a modified minimisation algorithm that incorporated a stochastic component. Patients and investigators were not masked to treatment allocation. The primary endpoint was event-free survival. Analyses were by intention to treat. This observational study is a follow-up of the MInT trial, which was stopped in 2003, and is registered at ClinicalTrials.gov, number NCT00400907. Findings The intention-to-treat population included 410 patients assigned to chemotherapy alone and 413 assigned to chemotherapy plus rituximab. After a median follow-up of 72 months (range 0·03–119), 6-year event-free survival was 55·8% (95% CI 50·4–60·9; 166 events) for patients assigned to chemotherapy alone and 74·3% (69·3–78·6; 98 events) for those assigned to chemotherapy plus rituximab (difference between groups 18·5%, 11·5–25·4, log-rank p vs 71·0% [65·1–76·1], log-rank p=0·005). 18 (4·4%, 95% CI 2·6–6·9) second malignancies occurred in the chemotherapy-alone group and 16 (3·9%, 2·2–6·2) in the chemotherapy and rituximab group (Fisher's exact p=0·730). Interpretation Rituximab added to six cycles of CHOP-like chemotherapy improved long-term outcomes for young patients with good-prognosis diffuse large-B-cell lymphoma. The definition of two prognostic subgroups allows a more refined therapeutic approach to these patients than does assessment by IPI alone. Funding Hoffmann–La Roche.read more
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CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell Lymphoma
Bertrand Coiffier,Eric Lepage,Josette Brière,Raoul Herbrecht,Hervé Tilly,Reda Bouabdallah,Pierre Morel,Eric Van Den Neste,Gilles Salles,Philippe Gaulard,Felix Reyes,Pierre Lederlin,Christian Gisselbrecht +12 more
TL;DR: A randomized trial to compare CHOP chemotherapy plus rituximab with CHOP alone in elderly patients with diffuse large-B-cell lymphoma found the rate of complete response was significantly higher in the group that received CHOP plus r ituximabs than in thegroup that receivedCHOP alone.
Journal Article
A predictive model for aggressive non-Hodgkin's lymphoma
Margaret A. Shipp,D. P. Harrington,James R. Anderson,James Olen Armitage,Gianni Bonadonna,G. Brittinger,Fernando Cabanillas,George P. Canellos,Bertrand Coiffier,Joseph M. Connors,R. A. Cowan,D. Crowther,Steve Dahlberg,M. Engelhard,Richard I. Fisher,Christian Gisselbrecht,Sandra J. Horning,Eric Lepage,T. A. Lister,J. H. Meerwaldt,Emili Montserrat,Nis I. Nissen,M. M. Oken,Bruce A. Peterson,Carlo Tondini,W. A. Velasquez,B. Y. Yeap +26 more
TL;DR: The international index and the age-adjusted international index should be used in the design of future therapeutic trials in patients with aggressive non-Hodgkin's lymphoma and in the selection of appropriate therapeutic approaches for individual patients.
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Report of an International Workshop to Standardize Response Criteria for Non-Hodgkin's Lymphomas
Bruce D. Cheson,Sandra J. Horning,B Coiffier,Margaret A. Shipp,Richard I. Fisher,J Connors,T A Lister,Julie M. Vose,Antonio J. Grillo-Lopez,A Hagenbeek,F Cabanillas,D Klippensten,W Hiddemann,R A Castellino,Nancy L. Harris,James O. Armitage,W. D. Carter,Richard T. Hoppe,George P. Canellos +18 more
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Nancy L. Harris,Elaine S. Jaffe,Jacques Diebold,G. Flandrin,H. Konrad Muller-Hermelink,James W. Vardiman,T. Andrew Lister,Clara D. Bloomfield +7 more
TL;DR: The experience of developing the WHO Classification has produced a new and exciting degree of cooperation and communication between oncologists and pathologists from around the world, which should facilitate progress in the understanding and treatment of hematologic malignancies.
Journal ArticleDOI
CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group
Michael Pfreundschuh,Lorenz Trümper,Anders Österborg,Ruth Pettengell,Marek Trneny,Kevin Imrie,David D.F. Ma,Devinder Gill,Jan Walewski,Pier Luigi Zinzani,Rolf A. Stahel,Stein Kvaløy,Ofer Shpilberg,Ulrich Jaeger,Mads Hansen,Tuula Lehtinen,Armando López-Guillermo,Claudia Corrado,Adriana Scheliga,Noel Milpied,Myriam Mendila,Michelle Rashford,Evelyn Kuhnt,Markus Loeffler +23 more
TL;DR: Rituximab added to six cycles of CHOP is an effective treatment for young patients with good-prognosis diffuse large-B-cell lymphoma and the definition of two prognostic subgroups allows for a more refined therapeutic approach for these patients.
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