In this study, older patients (60 to 80 years) with a type of lymphoma called diffuse large B-cell lymphoma were given either CHOP chemotherapy alone or CHOP with the drug rituximab. Adding rituximab meant that more patients had a complete response and lived longer without the disease coming back or growing. Important side effects did not differ meaningfully between the two groups.
Untreated large B-cell lymphoma (DLBCL)
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Rituximab | 375 mg/m² | IV | Day 1 |
| Cyclophosphamide | 750 mg/m² | IV | Day 1 |
| Doxorubicin | 50 mg/m² | IV | Day 1 |
| Vincristine | 1.4 mg/m² | IV | Day 1 |
| Prednisone | 100 mg once daily | Oral | Days 1–5 |
The doses are those of the POLARIX control arm as given in the polatuzumab vedotin label; in Pola-R-CHP, vincristine is replaced by polatuzumab vedotin 1.8 mg/kg. Hepatitis B screening before rituximab.
Diffuse large B-cell lymphoma and other aggressive B-cell lymphomas
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Rituximab | 375 mg/m² | IV (or 1400 mg subcutaneous from cycle 2) | Day 1 |
| Cyclophosphamide | 750 mg/m² | IV | Day 1 |
| Doxorubicin | 50 mg/m² | IV | Day 1 |
| Vincristine | 1.4 mg/m² (maximum 2 mg) | IV | Day 1 |
| Prednisone | 100 mg | Oral | Days 1 to 5 |
Rituximab as in LNH98-5; the CHOP doses are those of the R-CHOP arm of the POLARIX study, given in the polatuzumab label.
Dose source:.
On the page “R-CHOP regimen: dose, schedule and practical points”
Previously untreated diffuse large B-cell lymphoma
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Rituximab | 375 mg/m² | IV infusion (rate as in the prescribing notes) | Day 1 of each cycle |
| CHOP | According to protocol | IV/oral | Every 3 weeks |
From cycle 2, a 90-minute infusion is allowed (conditions under "Prescribing notes").
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Eight cycles of CHOP every 3 weeks: cyclophosphamide 750 mg/m², doxorubicin 50 mg/m² and vincristine 1.4 mg/m² (maximum 2 mg) on day 1, and prednisolone 40 mg/m² per day on days 1 to 5 (197 patients).
The same CHOP (8 cycles every 3 weeks) plus rituximab 375 mg/m² on day 1 of each cycle (202 patients).
Source of the regimen details: CHOP and rituximab doses: EMA Summary of Product Characteristics (SmPC) for MabThera, section 5.1 (trial of 399 older patients with DLBCL); FDA label for Rituxan (DailyMed, section 14.3, NHL Study 8)
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Previously untreated older patients aged 60 to 80 years with diffuse large B-cell lymphoma. According to the FDA label (NHL Study 8): 80% stage III or IV, 60% age-adjusted IPI of 2 or more, 80% ECOG below 2, 66% elevated LDH and 52% extranodal involvement at two or more sites.
The abstract does not explicitly state the primary endpoint. Reported measures included complete response rate, event-free survival and overall survival, as well as toxicity.
Clinically significant toxicity was not significantly greater in the CHOP-plus-rituximab group. According to the FDA label for Rituxan, in NHL Study 8 (this trial) the difference in cardiac adverse events was mainly due to supraventricular arrhythmia or tachycardia (4.5% with R-CHOP versus 1.0% with CHOP), and viral infection and grade 3 or 4 neutropenia were reported more often with R-CHOP; across Studies 7 and 8 (patients aged 60 years and older), fever (56% versus 46%), lung disorders (31% versus 24%), cardiac disorders (29% versus 21%) and chills (13% versus 4%) were more common with R-CHOP.
According to the abstract, adding rituximab to CHOP in older patients with diffuse large B-cell lymphoma improved complete response rate, event-free survival and overall survival without a significant increase in toxicity. The status of this approach in current clinical guidelines and drug approvals should be checked separately.
The abstract does not state the study's limitations. The reported follow-up was short (median two years), and only patients aged 60 to 80 years were included.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.
Who are you reading this site as?
Your choice applies to every page; change it any time from the bottom of the page.
Type to search...