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Blood, 15 January 2008, Vol. 111, No. 2, pp. 537-543. Prepublished online as a Blood First Edition Paper on October 30, 2007; DOI 10.1182/blood-2007-08-108415. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-08-108415v1 111/2/537    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Vellenga, E. Articles by Huijgens, P. C. Search for Related Content PubMed PubMed Citation Articles by Vellenga, E. Articles by Huijgens, P. C. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Rituximab improves the treatment results of DHAP-VIM-DHAP and ASCT in relapsed/progressive aggressive CD20+ NHL: a prospective randomized HOVON trial Edo Vellenga1, Wim L. J. van Putten2, Mars B. van 't Veer3, Josée M. Zijlstra4, Willem E. Fibbe5, Marinus H. J. van Oers6, Leo F. Verdonck7, Pierre W. Wijermans8, Gustaaf W. van Imhoff1, Pieternella J. Lugtenburg9, and Peter C. Huijgens4 1 Department of Hematology, University Medical Center, Groningen; 2 Hovon Data Center, Erasmus Medical Center, Rotterdam; 3 Department of Hematology, Erasmus Medical Center/location Daniel, Rotterdam; 4 Department of Hematology, Free Universiteit Medical Center (VUMC), Amsterdam; 5 Department of Hematology, Leiden University Medical Center (LUMC), Leiden; 6 Department of Hematology, Academic Medical Centre (AMC), Amsterdam; 7 Department of Hematology, University Medical Center, Utrecht; 8 Department of Hematology, Leyenburg Hospital, the Hague; and 9 Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands We evaluated the role of rituximab during remission induction chemotherapy in relapsed aggressive CD20+ non-Hodgkin lymphoma. Of 239 patients, 225 were evaluable for analysis. Randomized to DHAP (cisplatin-cytarabine-dexamethasone)-VIM (etoposide-ifosfamide-methotrexate)-DHAP (cisplatin-cytarabine-dexamethasone) chemotherapy with rituximab (R; R-DHAP arm) were 119 patients (113 evaluable) and to chemotherapy without rituximab (DHAP arm) 120 patients (112 evaluable). Patients in complete remission (CR) and partial remission (PR) after 2 chemotherapy courses were eligible for autologous stem-cell transplantation. After the second chemotherapy cycle, 75% of the patients in the R-DHAP arm had responsive disease (CR or PR) versus 54% in the DHAP arm (P = .01). With a median follow-up of 24 months, there was a significant difference in failure-free survival (FFS24; 50% vs 24% vs, P < .001), and progression free survival (PFS24; 52% vs 31% P < .002) in favor of the R-DHAP arm. Cox-regression analysis demonstrated a significant effect of rituximab treatment on FFS24 (HR 0.41, 95% confidence interval [CI] 0.29-0.57 versus 0.51, 95% CI 0.37-0.70) and overall-survival (OS24: HR 0.60 [0.41-0.89] vs 0.76 [0.52-1.10]) when adjusted for time since upfront treatment, age, World Health Organization performance status, and secondary age-adjusted international prognostic index. These results demonstrate improved FFS and PFS for relapsed aggressive B-cell NHL if rituximab is added to the re-induction chemotherapy regimen. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: U. Vitolo, A. Chiappella, E. Angelucci, G. Rossi, A. M. Liberati, M. G. Cabras, B. Botto, G. Ciccone, G. Gaidano, L. Falchi, et al. Dose-dense and high-dose chemotherapy plus rituximab with autologous stem cell transplantation for primary treatment of diffuse large B-cell lymphoma with a poor prognosis: a phase II multicenter study Haematologica, September 1, 2009; 94(9): 1250 - 1258. [Abstract] [Full Text] [PDF] R. Sud and J. W. Friedberg Salvage therapy for relapsed or refractory diffuse large B-cell lymphoma: impact of prior rituximab Haematologica, December 1, 2008; 93(12): 1776 - 1780. [Full Text] [PDF] A. Martin, E. Conde, M. Arnan, M. A. Canales, G. Deben, J. M. Sancho, R. Andreu, A. Salar, P. Garcia-Sanchez, L. Vazquez, et al. R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study Haematologica, December 1, 2008; 93(12): 1829 - 1836. [Abstract] [Full Text] [PDF] C. Stolz, G. Hess, P. S. Hahnel, F. Grabellus, S. Hoffarth, K. W. Schmid, and M. Schuler Targeting Bcl-2 family proteins modulates the sensitivity of B-cell lymphoma to rituximab-induced apoptosis Blood, October 15, 2008; 112(8): 3312 - 3321. [Abstract] [Full Text] [PDF]

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