Journal of Experimental & Clinical Cancer Research (Aug 2009)

Impact of relative dose intensity (RDI) in CHOP combined with rituximab (R-CHOP) on survival in diffuse large B-cell lymphoma

  • Koh Ki-Ryang,
  • Ohsawa Masahiko,
  • Takeoka Yasunobu,
  • Nakane Takahiko,
  • Koh Hideo,
  • Inoue Eri,
  • Aimoto Mizuki,
  • Sakamoto Erina,
  • Kanashima Hiroshi,
  • Aimoto Ran,
  • Nakamae Hirohisa,
  • Terada Yoshiki,
  • Yamane Takahisa,
  • Nakao Yoshitaka,
  • Ohta Kensuke,
  • Mugitani Atsuko,
  • Teshima Hirofumi,
  • Hino Masayuki

DOI
https://doi.org/10.1186/1756-9966-28-116
Journal volume & issue
Vol. 28, no. 1
p. 116

Abstract

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Abstract Background Recently, maintaining higher relative dose intensity (RDI) of chemotherapeutic drugs has become a widespread practice in an attempt to achieve better outcomes in the treatment of aggressive lymphoma. The addition of rituximab to chemotherapy regimens has significantly improved outcome in diffuse large B-cell lymphoma (DLBL). However, it is unknown if higher RDI in chemotherapy when combined with rituximab leads to a better outcome in aggressive B-cell lymphoma. Methods We retrospectively evaluated the impact of the RDI of initial chemotherapy (consisting of cyclophosphamide, doxorubicin, vincristine and prednisolone with rituximab (R-CHOP) on outcome in 100 newly diagnosed DLBL patients. Results A multivariate Cox regression model showed that RDI trended towards a significant association with mortality [hazard ratio per 0.1 of RDI = 0.8; 95% confidence interval 0.6–1.0; P = 0.08]. Additionally, on multivariate logistic analysis, advanced age was a significant factor for reduced RDI. Conclusion Our data suggest that in DLBL patients, mortality was affected by RDI of R-CHOP as the initial treatment, and the retention of a high RDI could therefore be crucial.