1. ¹Department of Hematology, Cancer Center Institut J Paoli - I Calmettes, Marseille Cedex, France
2. ²Department of Medicine, Cancer Center Léon Bérard, Lyon, France
3. ³Department of Medicine, Hopital La Durance, Avignon, France

Correspondence: Dr R Bouabdallah, Department of Hematology, Cancer Center Institut J Paoli – I Calmettes, 232, Boulevard Sainte-Marguerite, BP 156, 13273 Marseille Cedex 09, France. E-mail: bouabdr@marseille.fnclcc.fr

Received 23 November 2005; Revised 19 April 2006; Accepted 2 May 2006; Published online 12 June 2006.

Abstract

The potential benefit of rituximab as adjuvant to high-dose therapy (HDT) has been investigated in patients under 60 years with poor-risk (age-adjusted international prognostic index at 2–3) CD20+ diffuse large B-cell lymphoma (DLBCL). The treatment consisted of four cycles of high-dose CEOP (cyclophosphamide, epirubicin, vincristine, prednisone), plus etoposide and cisplatin during the two last cycles. Peripheral blood stem cells were collected after cycle 1, and reinfused after cycles 3 and 4. Four weekly rituximab infusions were subsequently delivered. Among the 36 patients included, 30 could complete chemotherapy schedule, and 24/36 received rituximab. A complete response occured in 26/36 patients (72%). With a median follow-up of 30 months, the estimated 5-year overall survival (OS) and event-free survival (EFS) rates (means.d.) were 6516 and 6315%, respectively. For the 24 patients who received both chemotherapy and rituximab, the estimated 5-year OS and EFS rates were 8614 and 8215%. These data suggest that rituximab after HDT is feasible. Both complete remission rate and survival curves compare favorably with the poor outcome usually observed in high-risk DLBCL patients managed with HDT without rituximab.