Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 28, 2010; 16(20): 2526-2530
Published online May 28, 2010. doi: 10.3748/wjg.v16.i20.2526
Efficacy of rituximab in gastric diffuse large B cell lymphoma patients
Davide Leopardo, Giuseppe Di Lorenzo, Amalia De Renzo, Piera Federico, Serena Luponio, Carlo Buonerba, Elide Matano, Gerardina Merola, Martina Imbimbo, Enzo Montesarchio, Antonio Rea, Maria Carmela Merola, Sabino De Placido, Giovannella Palmieri
Davide Leopardo, Giuseppe Di Lorenzo, Piera Federico, Carlo Buonerba, Elide Matano, Gerardina Merola, Martina Imbimbo, Sabino De Placido, Giovannella Palmieri, Department of Endocrinology and Clinical Oncology, University Federico II, 80131, Naples, Italy
Amalia De Renzo, Serena Luponio, Department of Hematology, University Federico II, 80131, Naples, Italy
Enzo Montesarchio, Antonio Rea, Oncology Clinical Division, Hospital “D. Cotugno”, 80131, Naples, Italy
Maria Carmela Merola, Oncology Clinical Division, Clinica Villa Maria, 83036, Mirabella Eclano, Italy
Author contributions: Leopardo D and Di Lorenzo G equally contributed to this paper; Leopardo D, Di Lorenzo G, De Renzo A, De Placido S and Palmieri G were responsible for the study conception and design; Luponio S, De Renzo A, Federico P, Montesarchio E, Rea A, Merola MC, Buonerba C, Matano E, Merola G and Imbimbo M provided the study patients; Leopardo D, Di Lorenzo G and Palmieri G collected and assembled the study data; Palmieri G, Leopardo D, Di Lorenzo G and De Placido S interpreted and analyzed the study data; Leopardo D, Di Lorenzo G and Palmieri G wrote the manuscript; all authors gave final approval of the manuscript.
Correspondence to: Giuseppe Di Lorenzo, MD, PhD, Department of Endocrinology and Clinical Oncology, University Federico II, 80131, Naples, Italy. giuseppedilorenzoncol@hotmail.com
Telephone: +39-81-7463660 Fax: +39-81-8997370
Received: December 19, 2009
Revised: March 18, 2010
Accepted: March 25, 2010
Published online: May 28, 2010
Abstract

AIM: To evaluate retrospectively the efficacy of rituximab plus chemotherapy in gastric diffuse large B cell lymphoma (DLBCL).

METHODS: Sixty patients (median age: 58 years) with histologically confirmed gastric DLBCL treated at four Italian institutions between 2000 and 2007, were included in this analysis. Patients were selected by stage (I-IV, Lugano staging system), European Cooperative Oncology Group performance status (0-2) and treatment strategies. Treatment strategies were chemotherapy alone (group A, n = 30) [scheduled as cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) and CHOP-like], and chemotherapy combined with rituximab (group B, n = 30). The primary end point of the study was complete response (CR) rate; the secondary end points were disease-free survival (DFS) at 5 years and overall survival (OS).

RESULTS: Median follow-up was 62 mo (range: 31-102 mo). We observed a significant difference between the two groups (A vs B) in terms of CR [76.6% (23/30) vs 100%, P = 0.04) and DFS at 5 years [73.3% (22/30) vs 100%, P = 0.03). To date, 19 group A (63.3%) patients are alive and 11 have died, while all group B patients are alive. No significant differences in toxicity were observed between the two groups.

CONCLUSION: Rituximab in combination with chemotherapy improves CR rate, DFS and OS. Further prospective trials are needed to confirm our results.

Keywords: Rituximab; Diffuse large B cell lymphoma; Stomach neoplasms; Chemotherapy