CHOP-like Regimen in Combination with Rituximab and Peginterferon Alpha-2b in Newly-diagnosed Diffuse Large B-cell Non-Hodgkin’s Lymphoma: Experience in a Chinese Center

OBJECTIVE To evaluate the efficacy of rituximab combined with CHOP-like regimen with or without IFN in patients newly diagnosed diffuse large B-cell Non-Hodgkin’s lymphoma (DLBCL). METHODS From January 2003 to July 2008, 51 patients received CHOP-like chemotherapy (cyclophosphamide 750 mg/m2, epirubicin 80 mg/m2, vindesine 2.8 mg/m2 on day 1 , and prednisolone 100 mg/day on day 1 to day 5). Thirty- tne patients received CHOPR-like treatment (rituximab 375 mg/m2 1 day before CHOP-like chemotherapy). Twenty patients received CHOP-like regimen in combination with peginterferon (pegIFN) (1 μg/kg on day 5) and rituximab (on day 6). RESULTS The CR (complete remission) rate in the CHOPR-like (with or without pegIFN) group and in the CHOP-like group was 78.4% and 45.1% (P = 0.005), respectively. The estimated mean time of overall survival (OS) in the CHOPR-like group and CHOP-like group was 58.7 ± 2.8 and 36.4 ± 3.4 months, respectively (P = 0.002). The rates of CR and OR (overall remission) in CHOPR-like with IFN arm were 85.0% and 95.0%, and the rates of those in CHOPR-like without IFN arm were 74.2% and 87.0% (P > 0.05). The estimated mean time of 4-year-PFS (progression-free survival) in CHOPR-like with IFN arm and in CHOPR-like without IFN arm was 62.9 ± 3.0 months and 51.0 ± 4.6 months (P = 0.092), respectively. In the CHOPR-like with IFN arm, no patient relapsed after achieving CR, while the estimated rate of 4-year-DFS (disease-free survival) in the patients who reached CR in the CHOPR-like without IFN arm was (63.4 ± 19.3)% (P = 0.061). CONCLUSION Rituximab combined with CHOP-like chemotherapy improved the prognosis of DLBCL patients. The IFN may help to improve the quality and duration of response of DLBCL patients treated with rituximab and CHOP-like regimen.