Current strategies for the treatment of diffuse large B cell lymphoma

Current Opinion in Hematology

Volumn 12, Issue 4, 2005, Pages 259-265

  Coiffier, Bertrand ^a,b  

^a HOSPICES CIVILS DE LYON   (France)

^b Hematology Department   (France)

Author keywords

Diffuse large b cell lymphoma; Dose dense regimens; Dose intense regimens; High dose therapy with autologous transplant; Rituximab containing regimens

Indexed keywords

ANTINEOPLASTIC AGENT; ANTIRETROVIRUS AGENT; BLEOMYCIN; CYCLOPHOSPHAMIDE; DOXORUBICIN; ETOPOSIDE; MITOXANTRONE; PREDNISONE; RITUXIMAB; VINCRISTINE; VINDESINE;

B CELL LYMPHOMA; CANCER RELAPSE; CANCER SURVIVAL; CLINICAL TRIAL; DISEASE ASSOCIATION; DRUG DOSE REDUCTION; DRUG DOSE REGIMEN; HIGH RISK PATIENT; HIGHLY ACTIVE ANTIRETROVIRAL THERAPY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INTERMETHOD COMPARISON; LARGE CELL LYMPHOMA; MONOTHERAPY; NONHODGKIN LYMPHOMA; PRIORITY JOURNAL; PROGNOSIS; REVIEW; SURVIVAL TIME; TREATMENT INDICATION; TREATMENT OUTCOME;

ANTIBODIES, MONOCLONAL; ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; COMBINED MODALITY THERAPY; HUMANS; LYMPHOMA, B-CELL; LYMPHOMA, LARGE-CELL, DIFFUSE; NEOPLASM RECURRENCE, LOCAL; SALVAGE THERAPY;

EID: 23044436563     PISSN: 10656251     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.moh.0000168519.98990.94     Document Type: Review

References (44)

1. Coiffier B. Treatment of diffuse large B-cell lymphoma. Curr Hematol Rep 2005; 4:7-14.
2. Coiffier B, Reyes F. Best treatment of aggressive lymphomas: a French perspective. Oncology 2005. (in press)
3. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med 1993; 329:987-994.
4. Zucca E, Zinzani PL. Understanding the group of peripheral T-cell lymphomas, unspecified. Curr Hematol Rep 2005; 4:23-30.
5. Rosenwald A, Wright G, Leroy K, et al. Molecular diagnosis of primary mediastinal B cell lymphoma identifies a clinically favorable subgroup of diffuse large B cell lymphoma related to Hodgkin lymphoma. J Exp Med 2003; 198:851-862.
6. Savage KJ, Monti S, Kutok JL, et al. The molecular signature of mediastinal large B-cell lymphoma differs from that of other diffuse large B-cell lymphomas and shares features with classical Hodgkin lymphoma. Blood 2003; 102:3871-3879.
7. Rosenwald A, Wright G, Chan WC, et al. The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med 2002; 346:1937-1947.
8. Lossos IS, Czerwinski DK, Alizadeh AA, et al. Prediction of survival in diffuse large-B-cell lymphoma based on the expression of six genes. N Engl J Med 2004; 350:1828-1837. This paper identified the most important genes associated with poor response to chemotherapy in patients with DLBCL. The only drawback was that these patients were treated before the rituximab era. It will allow the discovery of specific therapy aiming at changing the effect of these genes.
9. Gascoyne RD. Emerging prognostic factors in diffuse large B cell lymphoma. Curr Opin Oncol 2004; 16:436-441. This is a good review of recently identified molecular and genetic prognostic parameters.
10. Burton C, Ell P, Linch D. The role of PET imaging in lymphoma. Br J Haematol 2004; 126:772-784. This is a good review of the interest in and indications for positron emission tomography in lymphoma patients.
11. Zinzani PL, Fanti S, Battista G, et al. Predictive role of positron emission tomography (PET) in the outcome of lymphoma patients. Br J Cancer 2004; 91:850-854.
12. Spaepen K, Stroobants S, Dupont P, et al. Prognostic value of pretransplantation positron emission tomography using fluorine 18-fluorodeoxyglucose in patients with aggressive lymphoma treated with high-dose chemotherapy and stem cell transplantation. Blood 2003; 102:53-59.
13. Fisher RI, Gaynor ER, Dahlberg S, et al. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med 1993; 328:1002-1006.
14. Coiffier B. Increasing chemotherapy intensity in aggressive lymphomas: a renewal? J Clin Oncol 2003; 21:2457-2459.
15. Shipp MA, Neuberg D, Janicek M, et al. High-dose CHOP as initial therapy for patients with poor-prognosis aggressive non-Hodgkin's lymphoma: a dose-finding pilot study. J Clin Oncol 1995; 13:2916-2923.
16. Blayney DW, LeBlanc ML, Grogan T, et al. Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma: a phase II study of the Southwest Oncology Group (SWOG 9349). J Clin Oncol 2003; 21:2466-2473.
17. Tilly H, Lepage E, Coiffier B, et al. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood 2003; 102:4284-4289.
18. Pfreundschuh M, Trumper L, Kloess M, et al. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL Blood 2004; 104:634-641. This was the final report of the CHOP-14 study in elderly patients.
19. Coiffier B, Haioun C, Ketterer N, et at. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: a multicenter phase II study. Blood 1998; 92:1927-1932.
20. Vose JM, Link BK, Grossbard ML, et al. Phase II study of rituximab in combination with CHOP chemotherapy in patients with previously untreated, aggressive non-Hodgkin's lymphoma. J Clin Oncol 2001; 19:389-397.
21. Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002; 346:235-242.
22. Habermann TM, Weller EA, Morrison VA, et al. Phase III trial of rituximab-CHOP (R-CHOP) vs. CHOP with a second randomization to maintenance rituximab (MR) or observation in patients 60 years of age and older with diffuse large B-cell lymphoma (DLBCL). Blood 2003; 102(Suppl 1):6a.
23. Pfreundschuh MG, Trümper L, Ma D, et al. Randomized intergroup trial of first line treatment for patients <=60 years with diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) with a CHOP-like regimen with or without the anti-CD20 antibody rituximab: early stopping after the first interim analysis. In: ASCOP, editor. ASCO; 2004; New Orleans: Proc of American Society of Clinical Oncology meeting 2004; 22:556.
24. Sehn LH, Donaldson J, Chanabhai M, et al. Introduction of combined CHOP-rituximab therapy dramatically improved outcome of diffuse large B-cell lymphoma (DLBC) in British Columbia (BC). Blood 2003; 102(Suppl 1):29a.
25. Coiffier B. Dose intensity or monoclonal antibody in first-line treatment. Hematol J 2004; 5 (Suppl 3):S154-S158. This paper reviews the different therapeutic strategies for patients with DLBCL.
26. Feugier P, Hoof AV, Sebban C, et al. Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma. J Clin Oncol 2005; 23: (In press) The authors give a 5-year update of the GELA study comparing CHOP with R-CHOP in elderly patients. The results showed that the benefit persists with time and even seems to increase. This is the randomized study with the longer follow-up evaluating the combination of rituximab with chemotherapy in lymphoma.
27. Epelbaum R, Haim N, Ben-Shahar M, et al. Dose-intensity analysis for CHOP chemotherapy in diffuse aggressive large cell lymphoma. Isr J Med Sci 1988; 24:533-538.
28. Kwak LW, Halpern J, Olshen RA, Horning SJ. Prognostic significance of actual dose intensity in diffuse large cell lymphoma: results of a tree structured survival analysis. J Clin Oncol 1990; 8:963-977.
29. Lepage E, Gisselbrecht C, Haioun C, et al. Prognostic significance of received relative dose intensity in non-Hodgkin's lymphoma patients: application to LNH-87 protocol. Ann Oncol 1993; 4:651-656.
30. Lee KW, Kim DY, Yun T, et al. Doxorubicin-based chemotherapy for diffuse large B-cell lymphoma in elderly patients: comparison of treatment outcomes between young and elderly patients and the significance of doxorubicin dosage. Cancer 2003; 98:2651-2656.
31. Miller TP, Dahlberg S, Cassady JR, et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate-and high-grade non-Hodgkin's lymphoma. N Engl J Med 1998; 339:21-26.
32. Horning SJ, Weller E, Kim K, et al. Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma: Eastern Cooperative Oncology Group study 1484. J Clin Oncol 2004; 22:3032-3038. This paper gives the results of the ECOG study evaluating the role of radiotherapy after CHOP chemotherapy in patients with localized lymphoma with a 10-year follow-up.
33. Reyes F, Lepage E, Ganem G, et al. Chemotherapy alone with the intensified ACVBP plus sequential consolidation regimen compared with three cycles of standard CHOP plus involved field radiotherapy for low risk localized aggressive lymphoma in patients less than 60 years of age. N Engl J Med 2005; 352:1197-1205. This is the recently published GELA study on the role of radiotherapy in patients with localized aggressive lymphoma. This study compare three CHOP plus involved field radiotherapy with ACVBP induction plus sequential consolidation. The overall survival was better with the ACVBP regimen than with CHOP plus radiotherapy.
34. Fillet G, Bonnet C, Mounier N, et al. Radiotherapy is unnecessary in elderly patients with localized aggressive non-Hodgkin's lymphoma: results of the GELA LNH 93-4 study. Blood 2003; 100:92a.
35. Haioun C, Lepage E, Gisselbrecht C, et al. Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin's lymphoma: final analysis of the prospective LNH87-2 protocol. A Groupe d'Etude des Lymphomes de l'Adulte Study. J Clin Oncol 2000; 18:3025-3030.
36. Rodriguez J, Caballero MD, Gutierrez A, et al. Autologous stem-cell transplantation in diffuse large B-cell non-Hodgkin's lymphoma not achieving complete response after induction chemotherapy: the GEL/TAMO experience. Ann Oncol 2004; 15:1504-1509. This was a retrospective analysis of high-dose therapy with autologous transplant in patients who reached only a partial response in the experience of the Spanish lymphoma group.
37. Milpied N, Deconinck E, Gaillard F, et al. Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med 2004; 350:1287-1295. The results of the randomized study done by the GOELAMS comparing CHOP with high-dose therapy in patients with aggressive lymphoma showed an advantage in terms of overall survival for patients with an aalPI score of 2.
38. Mounier N, Gisselbrecht C, Briere J, et al. Prognostic factors in patients with aggressive non-Hodgkin's lymphoma treated by front-line autotransplantation after complete remission: a cohort study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol 2004; 22:2826-2834. This analysis of prognostic parameter for overall survival in a cohort of patients treated with high-dose therapy and autologous transplant within the GELA showed that patients with T cell lymphoma respond less well than patients with DLBCL.
39. Mounier N, Gisselbrecht C, Briere J, et al. All aggressive lymphoma subtypes do not share similar outcome after front-line autotransplantation: a matched-control analysis by the Groupe d'Etude des Lymphomes de l'Adulte (GELA). Ann Oncol 2004; 15:1790-1797. This was the same cohort of patients as in [38], but here they were compared with patients treated with chemotherapy only in a matched analysis.
40. Kewalramani T, Zelenetz AD, Nimer SD, et al. Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma. Blood 2004; 103:3684-3688. This is a description of the rituximab with ifosfamide, carboplatin, and etoposide regimen and the results of the phase II trial in patients with relapsing aggressive B cell lymphoma.
41. Hoerr AL, Gao F, Hidalgo J, et al. Effects of pretransplantation treatment with rituximab on outcomes of autologous stem-cell transplantation for non-Hodgkin's lymphoma. J Clin Oncol 2004; 22:4561-4566. This is a retrospective analysis of the effect of rituximab on outcome after autologous transplant when given at the time of relapse before the stem cells are obtained.
42. Sparano JA, Lee S, Chen MG, et al. Phase II trial of infusional cyclophosphamide, doxorubicin, and etoposide in patients with HIV-associated non-Hodgkin's lymphoma: an Eastern Cooperative Oncology Group Trial (E1494). J Clin Oncol 2004; 22:1491-1500. This paper describes the CDE regimen in patients with HIV-related lymphoma and its results in patients treated or not treated with HAART.
43. Krishnan A, Molina A, Zaia J, et al. Durable remissions with autologous stem cell transplantation for high-risk HIV-associated lymphomas. Blood 2005; 105:874-878. This paper gives the results of HDT with autotransplant in a cohort of patients with HIV-related lymphoma.
44. Costello RT, Zerazhi H, Charbonnier A, et al. Intensive sequential chemotherapy with hematopoietic growth factor support for non-Hodgkin lymphoma in patients infected with the human immunodeficiency virus. Cancer 2004; 100:667-676. This is another phase II study of HDT in patients with HIV-related lymphoma.