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Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Japan: a retrospective analysis of 1,057 cases from Kyushu Lymphoma Study Group

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Abstract

We performed a retrospective analysis of patients with diffuse large B cell lymphoma treated with rituximab plus CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) as a first-line therapy at 22 hospitals of the Kyushu Lymphoma Study Group. During the period 1996–2005, 1,057 patients (aged 22–90 years) were analyzed. Of these, 678 were treated with CHOP, and 379 were treated with rituximab plus CHOP (R-CHOP). The complete response rate was 59.9% in the CHOP group and 67.0% in the R-CHOP group (P < 0.001). Three-year progression-free survival (PFS) and overall survival (OS) rates were significantly higher in the R-CHOP group than in the CHOP group (61.3 vs. 45.6% for PFS, P < 0.001; 68.3 vs. 54.5% for OS, P < 0.001). The International Prognostic Index was a good prognostic marker for both groups; a survival benefit of rituximab addition was found for each risk subgroup and also for both age groups (≤60 and >60 years). Among 345 patients who received localized radiation therapy, the adding rituximab to CHOP attenuated the survival difference between CHOP and R-CHOP groups (P = 0.104), compared with no radiation group (P < 0.001). Results of this large-scale, multicenter study confirm that rituximab plus CHOP provided a greater survival benefit than CHOP alone.

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Acknowledgments

This study was performed in collaboration with the many hematologists and pathologists associated with the Kyushu Lymphoma Study Group. We express our appreciation to all of them.

Author information

Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan

    Ritsuko Seki, Koji Nagafuji & Takashi Okamura

  2. Department of Pathology, Kurume University School of Medicine, Kurume, Japan

    Koichi Ohshima

  3. Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan

    Ritsuko Seki, Koichi Ohshima & Takashi Okamura

  4. Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan

    Tomoaki Fujisaki

  5. Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan

    Naokuni Uike

  6. Department of Internal Medicine, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan

    Fumio Kawano

  7. Department of Internal Medicine, Saga Prefectural Hospital Koseikan, Saga, Japan

    Hisashi Gondo

  8. Department of Internal Medicine, Miyazaki Prefectural Hospital, Miyazaki, Japan

    Shigeyoshi Makino

  9. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  10. Department of Hematology, Sasebo City General Hospital, Sasebo, Japan

    Yukiyoshi Moriuchi

  11. Department of Hematology, Iizuka Hospital, Iizuka, Japan

    Fumihiro Taguchi

  12. Department of Hematology, Harasanshin General Hospital, Fukuoka, Japan

    Tomohiko Kamimura

  13. Division of Clinical Hematology, Kumamoto City Hospital, Kumamoto, Japan

    Hiroyuki Tsuda

  14. Shimonoseki City Central Hospital, Shimonoseki, Japan

    Ryosuke Ogawa

  15. Department of Internal Medicine, Gastroenterology and Hematology, Faculty of Medicine, Miyazaki University, Kiyotake, Japan

    Kazuya Shimoda & Kiyoshi Yamashita

  16. Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan

    Keiko Suzuki

  17. Department of Internal Medicine, NTT Nishinippon Kyushu General Hospital, Kumamoto, Japan

    Hitoshi Suzushima

  18. Molecular Medicine Unit and Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Kunihiro Tsukazaki

  19. Department of Internal Medicine, Kyushu Kosei-nenkin Hospital, Kitakyushu, Japan

    Masakazu Higuchi

  20. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan

    Atae Utsunomiya

  21. Department of Internal Medicine, Saiseikai-Hita Hospital, Hita, Japan

    Masahiro Iwahashi

  22. Department of Hematology, St. Mary Hospital, Kurume, Japan

    Yutaka Imamura

  23. Division of Medical Oncology and Hematology, Department of Medicine, Fukuoka University Hospital, Fukuoka, Japan

    Kazuo Tamura

  24. Department of Internal Medicine, Fukuoka University Chikushi Hospital, Fukuoka, Japan

    Junji Suzumiya

  25. Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan

    Minoru Yoshida

  26. Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

    Yasunobu Abe

  27. Department of Hematology, Imamura Hon-in Hospital, Kagoshima, Japan

    Tadashi Matsumoto

  28. Division of Hematology, Department of Medicine, Kurume University School of Medicine, Japan 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Takashi Okamura

Authors
  1. Ritsuko Seki
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  2. Koichi Ohshima
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  3. Koji Nagafuji
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  4. Tomoaki Fujisaki
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  7. Hisashi Gondo
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  20. Masakazu Higuchi
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  21. Atae Utsunomiya
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  29. Takashi Okamura
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Corresponding author

Correspondence to Takashi Okamura.

Appendix: Kyushu Lymphoma Study Group

Appendix: Kyushu Lymphoma Study Group

Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine: Ritsuko Seki, Koji Nagafuji, Ken Tanaka, Takashi Okamura; Department of Pathology, Kurume University School of Medicine: Konomi Takasu, Kennosuke Karube, Koichi Ohshima; Department of Internal Medicine, Matsuyama Red Cross Hospital: Tsuyoshi Muta, Tomoaki Fujisaki; Department of Hematology, National Kyushu Cancer Center: Ilseung Choi, Naokuni Uike; Department of Internal Medicine, National Hospital Organization Kumamoto Medical Center: Michihiro Hidaka, Toshihiko Murayama, Fumio Kawano; Department of Internal Medicine, Saga Prefectural Hospital, Koseikan: Eijyou Matsuishi, Fumio Yamasaki, Hisashi Gondo; Department of Internal Medicine, Miyazaki Prefectural Hospital: Noriaki Kawano, Shigeyoshi Makino, Toru Hayashi; Department of Hematology, Hamanomachi Hospital: Tetsuya Eto, Shinichi Aishima; Department of Hematology, Sasebo City General Hospital: Yukiyoshi Moriuchi; Department of Hematology, Iizuka Hospital: Fumihiro Taguchi; Department of Hematology, Harasanshin General Hospital: Tomohiko Kamimura, Shinji Kouno; Division of Clinical Hematology, Kumamoto City Hospital: Hiroyuki Tsuda, Nobuyuki Arima; Shimonoseki City Central Hospital: Ryosuke Ogawa; Department of Internal Medicine, Gastroenterology and Hematology, Faculty of Medicine, Miyazaki University: Kazuya Shimoda, Kiyoshi Yamashita; Department of Internal Medicine, Koga General Hospital: Keiko Suzuki; Department of Internal Medicine, NTT Nishinippon Kyushu General Hospital: Hitoshi Suzushima; Molecular Medicine Unit and Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences: Kunihiro Tsukazaki, Masao Tomonaga; Department of Internal Medicine, Kyushu Kosei-nenkin Hospital: Masakazu Higuchi; Department of Hematology, Imamura Bun-in Hospital: Atae Utsunomiya; Department of Internal Medicine, Saiseikai-Hita Hospital: Masahiro Iwahashi; Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University: Yasunobu Abe; Department of Hematology, Imamura Hon-in Hospital: Toshimasa Kukita, Tadashi Matsumoto; Japanese Red Cross Kumamoto Health Care Center: Minoru Yoshida; First Department of Internal Medicine, Faculty of Medicine, Fukuoka University: Junji Suzumiya, Kazuo Tamura; Department of Hematology, St. Mary’s Hospital: Hiroto Jyoujima, Koichi Higaki, Yutaka Imamura; Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science: Naoki Harada, Mine Harada; Fukuoka Teishin Hospital: Tsunefumi Shibuya; Fukuoka Higashi Medical Center: Mika Kuroiwa; Department of Internal Medicine, Kitakyushu Municipal Medical Center: Yuji Ohno; Internal Medicine, Saga University: Eisaburo Sueoka; Department of Internal Medicine, Karatsu Red Cross Hospital: Masaharu Miyahara; National Hospital Organization Miyakonojo Hospital: Maeda Koichi; Department of Hematology, Kumamoto University School of Medicine: Fumihiko Matsuno; Department of Hematological and Immunological Medicine, Kagoshima University Hospital: Kimiharu Uozumi; Division of Endocrinology and Metabolism, Faculty of Medicine, University of Ryukyus: Masato Masuda.

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Seki, R., Ohshima, K., Nagafuji, K. et al. Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Japan: a retrospective analysis of 1,057 cases from Kyushu Lymphoma Study Group. Int J Hematol 91, 258–266 (2010). https://doi.org/10.1007/s12185-009-0475-2

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  • DOI: https://doi.org/10.1007/s12185-009-0475-2

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