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Blood, 15 February 2005, Vol. 105, No. 4, pp. 1417-1423.
Prepublished online as a Blood First Edition Paper on October 19, 2004; DOI 10.1182/blood-2004-08-3175.


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CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS

CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma

Robert Marcus, Kevin Imrie, Andrew Belch, David Cunningham, Eduardo Flores, John Catalano, Philippe Solal-Celigny, Fritz Offner, Jan Walewski, Joäo Raposo, Andrew Jack, and Paul Smith

From Addenbrooke's Hospital, Cambridge, United Kingdom; Toronto-Sunnybrook Regional Cancer Center, Toronto, ON, Canada; Cross Cancer Institute, Edmonton, AB, Canada; Royal Marsden Hospital, Surrey, United Kingdom; Hospital Gregorio Marañón, Madrid, Spain; Monash Medical Centre, Clayton, Australia; Clinique Victor Hugo, Le Mans, France; Dienst Hematologie, UZ Gent, Belgium; M. Sklodowska-Curie Memorial Institute, Warszawa, Poland; Hospital Santa Maria, Lisboa, Portugal; Leeds General Infirmary, Leeds, United Kingdom; and Cancer Research UK and University College London (UCL) Cancer Trials Centre, London, United Kingdom.

The combination of cyclophosphamide, vincristine, and prednisone (CVP) is one of several standard treatment options for advanced follicular lymphoma. This, like similar chemotherapeutic regimens, induces response rates of 60% to 80%, with a median response duration of under 2 years. Rituximab, a chimeric monoclonal antibody against CD20, is active in follicular lymphoma, both as monotherapy and in combination with chemotherapy. Previously untreated patients with stages III to IV follicular lymphoma were randomly assigned to receive either 8 cycles of CVP plus rituximab (R-CVP; n = 162) or CVP (n = 159). Overall and complete response rates were 81% and 41% in the R-CVP arm versus 57% and 10% in the CVP arm, respectively (P < .0001). At a median follow-up of 30 months, patients treated with R-CVP had a very significantly prolonged time to progression (median 32 months versus 15 months for CVP; P < .0001). Median time to treatment failure was 27 months in patients receiving R-CVP and 7 months in the CVP arm (P < .0001). Rituximab did not add significantly to the toxicity of CVP. The addition of rituximab to the CVP regimen significantly improves the clinical outcome in patients with previously untreated advanced follicular lymphoma, without increased toxicity.


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L. H. Sehn
Optimal Use of Prognostic Factors in Non-Hodgkin Lymphoma
Hematology, January 1, 2006; 2006(1): 295 - 302.
[Abstract] [Full Text] [PDF]


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M. S. Czuczman
Controversies in Follicular Lymphoma: "Who, What, When, Where, and Why?" (Not Necessarily in That Order!)
Hematology, January 1, 2006; 2006(1): 303 - 310.
[Abstract] [Full Text] [PDF]


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W. H. Wilson
R-CHOP strikes again with survival benefit in follicular lymphoma
Blood, December 1, 2005; 106(12): 3678 - 3679.
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W. Hiddemann, M. Kneba, M. Dreyling, N. Schmitz, E. Lengfelder, R. Schmits, M. Reiser, B. Metzner, H. Harder, S. Hegewisch-Becker, et al.
Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group
Blood, December 1, 2005; 106(12): 3725 - 3732.
[Abstract] [Full Text] [PDF]


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R. I. Fisher, M. LeBlanc, O. W. Press, D. G. Maloney, J. M. Unger, and T. P. Miller
New Treatment Options Have Changed the Survival of Patients With Follicular Lymphoma
J. Clin. Oncol., November 20, 2005; 23(33): 8447 - 8452.
[Abstract] [Full Text] [PDF]


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ASH ANNUAL MEETING ABSTRACTSHome page
P. Solal-Celigny, K. Imrie, A. Belch, K. S. Robinson, D. Cunningham, A. Rueda, J. Catalano, F. Offner, J. Walewski, J. Raposo, et al.
Mabthera (Rituximab) Plus CVP Chemotherapy for First-Line Treatment of Stage III/IV Follicular Non-Hodgkin's Lymphoma (NHL): Confirmed Efficacy with Longer Follow-Up.
Blood (ASH Annual Meeting Abstracts), November 16, 2005; 106(11): 350 - 350.
[Abstract]


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W. Hiddemann, C. Buske, M. Dreyling, O. Weigert, G. Lenz, R. Forstpointner, C. Nickenig, and M. Unterhalt
Treatment Strategies in Follicular Lymphomas: Current Status and Future Perspectives
J. Clin. Oncol., September 10, 2005; 23(26): 6394 - 6399.
[Abstract] [Full Text] [PDF]


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JCOHome page
D. G. Maloney
Immunotherapy for Non-Hodgkin's Lymphoma: Monoclonal Antibodies and Vaccines
J. Clin. Oncol., September 10, 2005; 23(26): 6421 - 6428.
[Abstract] [Full Text] [PDF]


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G. Lenz, M. Dreyling, M. Unterhalt, and W. Hiddemann
In Reply:
J. Clin. Oncol., September 1, 2005; 23(25): 6264 - 6266.
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C. Nabhan
Should We Transplant Indolent Lymphoma?
J. Clin. Oncol., September 1, 2005; 23(25): 6263 - 6264.
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T. Kober, N. Skoetz, S. Trelle, J. Bohlius, and A. Engert
Third Biannual Report of the Cochrane Haematological Malignancies Group
J Natl Cancer Inst, August 17, 2005; 97(16): E2 - E.
[Full Text]


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S. M. Ansell and J. Armitage
Non-Hodgkin Lymphoma: Diagnosis and Treatment
Mayo Clin. Proc., August 1, 2005; 80(8): 1087 - 1097.
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P. Feugier, A. Van Hoof, C. Sebban, P. Solal-Celigny, R. Bouabdallah, C. Ferme, B. Christian, E. Lepage, H. Tilly, F. Morschhauser, et al.
Long-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'Adulte
J. Clin. Oncol., June 20, 2005; 23(18): 4117 - 4126.
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M. Ghielmini
Multimodality Therapies and Optimal Schedule of Antibodies: Rituximab in Lymphoma as an Example
Hematology, January 1, 2005; 2005(1): 321 - 328.
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