Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Kobayashi,Yujin; Hatta,Yoshihiro; Hojo,Atsuko; Kura,Yoshimasa; Uchino,Yoshihito; Takahashi,Hiromichi; Kiso,Satomi; Hirabayashi,Yukio; Yagi,Mai; Kodaira,Hitomi; Kurita,Daisuke; Tanaka,Toshitake; Miura,Katsuhiro; Iriyama,Noriyoshi; Kobayashi,Sumiko; Sawada,Umihiko; Sugitani,Masahiko; Takeuchi,Jin

doi:10.3892/etm.2011.387

February 2012 Volume 3 Issue 2

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February 2012 Volume 3 Issue 2

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Article

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Authors:
- Yujin Kobayashi
- Yoshihiro Hatta
- Atsuko Hojo
- Yoshimasa Kura
- Yoshihito Uchino
- Hiromichi Takahashi
- Satomi Kiso
- Yukio Hirabayashi
- Mai Yagi
- Hitomi Kodaira
- Daisuke Kurita
- Toshitake Tanaka
- Katsuhiro Miura
- Noriyoshi Iriyama
- Sumiko Kobayashi
- Umihiko Sawada
- Masahiko Sugitani
- Jin Takeuchi
View Affiliations / Copyright

Affiliations: Department of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo 173-8610, Japan, Department of Hematology and Oncology, Kasukabe Municipal Hospital, Saitama 344-8588, Japan, Department of Hematology and Oncology, Kasukabe Municipal Hospital, Saitama 344-8588, Japan, Department of Pathology, Nihon University School of Medicine, Tokyo 173-8610, Japan
Pages: 304-308
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Published online on: November 22, 2011

https://doi.org/10.3892/etm.2011.387
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Abstract

The addition of rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone [CHOP (i.e., R-CHOP)] is considered to be the standard regimen for treating localized, primary gastric diffuse large B-cell lymphoma (PG-DLBCL). However, few studies have reported the long-term efficacy of R-CHOP therapy in the management of localized PG-DLBCL. In the present study, we performed a retrospective analysis of 11 patients with localized PG-DLBCL, who were treated with R-CHOP at Nihon University Itabashi Hospital and Kasukabe Municipal Hospital (Japan) from 2001 to 2008. Limited stage cancer was defined as stage I/II according to the Lugano staging system for gastrointestinal (GI) lymphomas. The relative dose intensity (RDI) of CHOP therapy was calculated for each patient. The median age of the patients was 68 years (range, 48-82). Gastralgia and anemia were common symptoms at initial presentation. All patients except 1 received 6 cycles of R-CHOP treatment without consolidative radiation therapy or prior surgery. RDI was maintained at over 80% in 9 out of 11 patients. All patients achieved complete remission and the estimated overall survival with a median follow-up of 54 months (range, 39-103) was 100%, without relapse or significant GI adverse effects, such as perforation or bleeding during R-CHOP treatment. No long-term adverse effects of rituximab were recorded during the observation period. Helicobacter pylori infection was diagnosed in 72.7% (8 cases) of the patients, but was eradicated in a limited number of patients. Our data suggest the feasibility and effectiveness of the addition of rituximab to conventional CHOP therapy in the management of localized PG-DLBCL.

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1.	C TondiniR GiardiniF BozzettiP ValagussaA SantoroR BertulliM BalzarottiA RoccaF LombardiAJ FerreriG BonadonnaCombined modality treatment for primary gastrointestinal non-Hodgkin’s lymphoma: the Milan Cancer Institute experienceAnn Oncol48318371993
2.	M BinnA Ruskoné-FourmestrauxE LepageC HaiounA DelmerP AegerterA LavergneC GuettierJC DelchierSurgical resection plus chemotherapy versus chemotherapy alone: comparison of two strategies to treat diffuse large B-cell gastric lymphomaAnn Oncol1417511757200310.1093/annonc/mdg495
3.	SS YoonDG CoitCS PortlockMS KarpehThe diminishing role of surgery in the treatment of gastric lymphomaAnn Surg2402837200410.1097/01.sla.0000129356.81281.0c15213615
4.	A AvilésMJ NamboN NeriJ Huerta-GuzmánI CuadraI AlvaradoC CastañedaR FernándezM GonzálezThe role of surgery in primary gastric lymphoma: results of a controlled clinical trialAnn Surg2404450200415213617
5.	P KochA ProbstWE BerdelNA WillichG ReinartzJ BrockmannR LierschF del ValleH ClasenC HirtTreatment results in localized primary gastric lymphoma: data of patients registered within the German multicenter study (GIT NHL 02/96)J Clin Oncol2370507059200510.1200/JCO.2005.04.03116129843
6.	A PsyrriS PapageorgiouT EconomopoulosPrimary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and managementAnn Oncol1919921999200810.1093/annonc/mdn52518647965
7.	AJ FerreriC MontalbánPrimary diffuse large B-cell lymphoma of the stomachCrit Rev Oncol Hematol636571200710.1016/j.critrevonc.2007.01.00317339119
8.	R RamI Ben-BassatO ShpilbergA PolliackP RaananiThe late adverse events of rituximab therapy - rare but there!Leuk Lymphoma5010831095200919399690
9.	B CoiffierE LepageJ BriereR HerbrechtH TillyR BouabdallahP MorelE van den NesteG SallesP GaulardF ReyesP LederlinC GisselbrechtCHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphomaN Engl J Med346235242200210.1056/NEJMoa01179511807147
10.	S WöhrerA PüspökJ DrachM HejnaA ChottM RadererRituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) for treatment of early-stage gastric diffuse large B-cell lymphomaAnn Oncol15108610902004
11.	TM HabermannEA WellerVA MorrisonRD GascoynePA CassilethJB CohnSR DakhilB WodaRI FisherBA PetersonSJ HorningRituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphomaJ Clin Oncol2431213127200610.1200/JCO.2005.05.100316754935
12.	P FeugierA van HoofC SebbanP Solal-CelignyR BouabdallahC FerméB ChristianE LepageH TillyF MorschhauserLong-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d’Etude des Lymphomes de l’AdulteJ Clin Oncol2341174126200515867204
13.	A RohatinerF d’AmoreB CoiffierD CrowtherM GospodarowiczP IsaacsonTA ListerA NortonP SalemM ShippR SomersReport on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphomaAnn Oncol539740019948075046
14.	KCWR GatterDiffuse large cell lymphomaWorld Health Organization Classification of Tumours: Tumours of Haematopoietic and Lymphoid TissuesES JaffeNL HarrisVJ ShaIARC PressLyon1711762001
15.	S Leide-SvegbornK StenströmM OlofssonS MattssonLE NilssonB NosslinK PauL JohanssonB ErlandssonR HellborgG SkogBiokinetics and radiation doses for carbon-14 urea in adults and children undergoing the Helicobacter pylori breath testEur J Nucl Med26573580199910.1007/s00259005042410369942
16.	WD CheyBC WongPractice Parameters Committee of the American College of GastroenterologyAmerican College of Gastroenterology guideline on the management of Helicobacter pylori infectionAm J Gastroenterol10218081825200710.1111/j.1572-0241.2007.01393.x17608775
17.	P MalfertheinerF MegraudC O’MorainF BazzoliE El-OmarD GrahamR HuntT RokkasN VakilEJ KuipersCurrent concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus ReportGut56772781200717170018
18.	L LaineD LewinW NaritokuR EstradaH CohenProspective comparison of commercially available rapid urease tests for the diagnosis of Helicobacter pyloriGastrointest Endosc44523526199610.1016/S0016-5107(96)70002-08934155
19.	BD ChesonB PfistnerME JuweidRD GascoyneL SpechtSJ HorningB CoiffierRI FisherA HagenbeekE ZuccaInternational Harmonization Project on LymphomaRevised response criteria for malignant lymphomaJ Clin Oncol25579586200710.1200/JCO.2006.09.240317242396
20.	R EpelbaumN HaimM Ben-ShaharY RonY CohenDose-intensity analysis for CHOP chemotherapy in diffuse aggressive large cell lymphomaIsr J Med Sci2453353819983060443
21.	T AndersonBA ChabnerRC YoungCW BerardAJ GarvinRM SimonVT DeVita JrMalignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer InstituteCancer5026992707198210.1002/1097-0142(19821215)50:12%3C2699::AID-CNCR2820501202%3E3.0.CO;2-A7139563
22.	G PapaxoinisS PapageorgiouD RontogianniV KaloutsiG FountzilasN PavlidisM DimopoulosC TsatalasN XirosT EconomopoulosPrimary gastrointestinal non-Hodgkin’s lymphoma: a clinicopathologic study of 128 cases in Greece. A Hellenic Cooperative Oncology Group study (HeCOG)Leuk Lymphoma47214021462006
23.	NA WillichG ReinartzEJ HorstG DelkerB ReersW HiddemannM TiemannR ParwareschB Grothaus-PinkeJ KocikP KochOperative and conservative management of primary gastric lymphoma: interim results of a German multicenter studyInt J Radiat Oncol Biol Phys46895901200010.1016/S0360-3016(99)00475-710705011
24.	B CoiffierG SallesDoes surgery belong to medical history for gastric lymphomas?Ann Oncol8419421199710.1023/A:10082546172709233518
25.	C ThieblemontB CoiffierLymphoma in older patientsJ Clin Oncol2519161923200710.1200/JCO.2006.10.5957
26.	Y KobayashiK MiuraA HojoY HattaT TanakaD KuritaN IriyamaS KobayashiJ TakeuchiCharlson Comorbidity Index is an independent prognostic factor among elderly patients with diffuse large B-cell lymphomaJ Cancer Res Clin Oncol13710791084201110.1007/s00432-010-0973-x21221637
27.	T HirakawaH YamaguchiN YokoseS GomiK InokuchiK DanImportance of maintaining the relative dose intensity of CHOP-like regimens combined with rituximab in patients with diffuse large B-cell lymphomaAnn Hematol89897904201010.1007/s00277-010-0956-720414658
28.	C BonnetG FilletN MounierG GanemTJ MolinaC ThiéblemontC FerméB QuesnelC MartinC GisselbrechtH TillyF ReyesGroupe d’Etude des Lymphomes de l’AdulteCHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Groupe d’Etude des Lymphomes de l’AdulteJ Clin Oncol25787792200717228021
29.	BG TaalJM BurgersP van HeerdeAA HartR SomersThe clinical spectrum and treatment of primary non-Hodgkin’s lymphoma of the stomachAnn Oncol48398461993
30.	BM AlemanRL HaasRW van der MaazenRole of radiotherapy in the treatment of lymphomas of the gastrointestinal tractBest Pract Res Clin Gastroenterol242734201010.1016/j.bpg.2009.12.00220206106
31.	W FischbachLong-term follow-up of gastric lymphoma after stomach conserving treatmentBest Pract Res Clin Gastroenterol247177201010.1016/j.bpg.2009.12.00520206110
32.	M AsakaT KimuraM KudoH TakedaS MitaniT MiyazakiK MikiDY GrahamRelationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese populationGastroenterology1027607661992
33.	PM WebbT KnightS GreavesA WilsonDG NewellJ ElderD FormanRelation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early lifeBMJ30875075319948142828
34.	M KiviAL JohanssonM ReillyY TindbergHelicobacter pylori status in family members as risk factors for infection in childrenEpidemiol Infect133645652200510.1017/S0950268805003900
35.	LT ChenJT LinJJ TaiGH ChenHZ YehSS YangHP WangSH KuoBS SheuCM JanLong-term results of anti-Helicobacter pylori therapy in early-stage gastric high-grade transformed MALT lymphomaJ Natl Cancer Inst9713451353200516174856
36.	M RadererA ChottJ DrachC MontalbanB DragosicsU JägerA PüspökC OsterreicherCC ZielinskiChemotherapy for management of localised high-grade gastric B-cell lymphoma: how much is necessary?Ann Oncol1310941098200210.1093/annonc/mdf17812176789
37.	U WinklerM JensenO ManzkeH SchulzV DiehlA EngertCytokine-release syndrome in patients with B-cell chronic lymphocytic leukemia and high lymphocyte counts after treatment with an anti-CD20 monoclonal antibody (rituximab, IDEC-C2B8)Blood94221722241999
38.	PI RafailidisOK KakisiK VardakasME FalagasInfectious complications of monoclonal antibodies used in cancer therapy: a systematic review of the evidence from randomized controlled trialsCancer10921822189200717429839
39.	A AvilésC CastañedaS CletoN NeriJ Huerta-GuzmánM GonzalezRituximab and chemotherapy in primary gastric lymphomaCancer Biother Radiopharm2425282009
40.	D LeopardoG Di LorenzoA De RenzoP FedericoS LuponioC BuonerbaE MatanoG MerolaM ImbimboE MontesarchioEfficacy of rituximab in gastric diffuse large B cell lymphoma patientsWorld J Gastroenterol1625262530201010.3748/wjg.v16.i20.252620503452
41.	S YamamotoH NakaseK YamashitaM MatsuuraM TakadaC KawanamiT ChibaGastrointestinal follicular lymphoma: review of the literatureJ Gastroenterol453703882010
42.	M RadererJ Paul de BoerRole of chemotherapy in gastric MALT lymphoma, diffuse large B-cell lymphoma and other lymphomasBest Pract Res Clin Gastroenterol241926201020206105

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

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