Rituximab plus CHOP (R-CHOP) overcomes bcl-2--associated resistance to chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL).

摘要: In diffuse large B-cell lymphoma (DLBCL), the combination of rituximab and CHOP (cyclophosphamide, doxorubicine, vincristine, prednisone; R-CHOP) has been shown to be more effective than for treatment elderly patients. Bcl-2 protein expression associated with poor prognosis in patients DLBCL. To establish whether or not reduces bcl-2-assoclated failure, we studied bcl-2 clinical outcome included Groupe d'Etude des Lymphomes de l'Adulte LNH-98-5 trial. Patients between 60 80 years age were randomized receive 8 cycles either R-CHOP every 3 weeks. Of 399 included, 292 histologically proven DLBCL had material available bcI-2 study. Tumors considered positive when at least 50% tumor cells expressed protein. There 193 (66%) bcl-2(+) 99 (34%) The response rates were, respectively, 78% 60% (P = .01) 76% 73% .7) bcl-2- At a median 2 follow-up, was significantly better overall survival (67% +/- 9% versus 48% 11%, P .004). there no statistically significant difference ( 72% 12% 67% 14%, .6). addition, event-free (58% 10% 32% 10%, < .001) but (60% 13% 40% 15%, .13). Multivariate analysis confirmed benefit These results suggest that is able prevent chemotherapy failure overexpression. (C) 2003 by American Society Hematology.