Chemotherapy plus Rituximab versus chemotherapy alone for B-cell non-Hodgkin's lymphoma

Concomitant application of rituximab with standard chemotherapy improves overall survival in patients with indolent lymphoma compared to chemotherapy alone.

A Cochrane review included 7 studies with a total of 1 943 subjects. Patients with follicular lymphoma, mantle cell lymphoma, or other indolent lymphomas were included in the meta-analysis. Single dosis of 375 mg/m² used for rituximab was equal in all included studies. The median observation time for all patients was 24 months (range = 18 to 39 months). Patients treated with R-chemo (Chemotherapy plus Rituximab) had better overall survival (HR for mortality 0.65; 95% CI 0.54 to 0.78), overall response (RR of tumour response 1.21; 95% CI 1.16 to 1.27), and disease control (HR of disease event 0.62; 95% CI 0.55 to 0.71) than patients treated with chemotherapy alone. R-chemo improved overall survival in patients with follicular lymphoma (HR for mortality 0.63; 95% CI 0.51 to 0.79, n=1 480) and in patients with mantle cell lymphoma (HR for mortality 0.60; 95% CI 0.37 to 0.98, n=260). However, in the latter case, there was heterogeneity among the trials (P 0.07), making the survival benefit less reliable. The relative risk for developing fever or leukocytopenia was statistically significantly higher in patients treated with R-chemo than in patients treated with chemotherapy alone (RR = 3.79; 95% CI 1.47 to 9.78 and RR = 1.31; 95% CI = 1.11 to 1.55, respectively).

Ədəbiyyat

1. Schulz H, Bohlius J, Skoetz N, Trelle S, Kober T, Reiser M, Dreyling M, Herold M, Schwarzer G, Hallek M, Engert A. Chemotherapy plus Rituximab versus chemotherapy alone for B-cell non-Hodgkin's lymphoma. Cochrane Database Syst Rev 2007 Oct 17;(4):CD003805.