Efficacy and safety of rituximab in combination with chemotherapy in the treatment of Non- Hodgkin's Lymphoma.

Abstract

Background Chemotherapy, radiation and autologous bone marrow transplant are conventional standard therapies in Non-Hodgkin's lymphoma (NHL). Nowadays the introduction of monoclonal antibodies has enhanced the specificity of treatment, reducing the toxicity and presenting synergism with conventional chemotherapy.

Purpose To compare rituximab efficacy and safety in combination with CHOP chemotherapy (cyclophosphamide, adriamycin, vincristine and prednisone) in the treatment of NHL in our hospital, with that published in the literature.

Materials and methods Retrospective observational study of 116 patients diagnosed with NHL who received chemotherapy with R-CHOP (rituximab-CHOP) between January 2005 and December 2010. The authors reviewed the medical history (100%) and the data were analysed using SPSS predictive analytics software. Were recorded: demographic data (age, sex); efficacy (complete response (CR), partial response (PR), overall response rate (ORR), progression and relapse, overall survival (OS) and event free survival (EFS)); toxicity (haematological and non-haematological).

Results 53.5% of patients were male and mean age at diagnosis was 59 years. The authors obtained an ORR of 80.2% (71.3% CR and 8.9% PR). 14.8% of patients did not respond, and 5% had an unknown response. The progression and relapse rates were 18.8% and 17.8% respectively. Projected median OS for responding patients was over 30 months and EFS after one year was 70.3%. Neutropenia, anaemia and thrombocytopenia rates were reported as 15.8%, 12.4% and 2.3% respectively. Infusion-related reactions were reported in 1.95% of patients, 72.2% during the first session. The detected rate of infection was relatively low, and 3.5% of all infections were microbiologically documented.

Conclusions The results obtained were comparable to those of published studies in the literature for the treatment arm with R-CHOP in randomised patients (GELA NHL-95.5 study group, U.S. Intergroup Study, Mabthera International Trial MINT study). Neutropenia rates were higher than those found in the study of McLaughlin et al, while the other cell lines the results were similar.