Abstract 2824

Introduction:

Diffuse large B-cell lymphoma (DLBCL) in general has been treated 6 or 8 cycles chemotherapy. Not a few patients have had adverse events during chemotherapy and stopped treatment because of treatment related toxicities. Favorable results were reported from NHL-BFM 90 trial on childhood and adolescents B-cell NHL with short intensive therapy courses depending on stage and tumor mass. Treatment was stratified into 3 risk groups and patients with initial complete resection received 2 therapy courses. We aimed to investigate effectiveness of short course chemotherapy for localized DLBCL after complete resection in adults.

Patients and Methods:

The records of Asan Medical Center registry for Non-Hodgkin's lymphoma were reviewed. Between March 2002 and March 2009, 18 patients were enrolled with DLBCL of stage I or II and complete resection before initial chemotherapy. All patients received 3 to 4 courses of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (R-CHOP) or CHOP without radiotherapy. Retrospective analysis of disease-free survival (DFS) and overall survival (OS) was performed.

Results:

The study cohort of 18 patients showed median age of 53.5 years (range 18–69 years) at diagnosis. Ten patients were males. The Ann Arbor stage was I in 14 patients, II in 4 patients. All patients of stage II had gastrointestinal lymphoma with regional lymph node involvement. Only 2 patients had B symptom. All patients were stratified into low-risk group according to international prognostic index (IPI). Most of patients (88.9%) had 3 cycles chemotherapy and 2 patients with 4 cycles. Fifteen patients were treated with R-CHOP and the others with CHOP. The median follow-up time was 27.5 months (range 6.1–100 months). The 2-year DFS was 100% and the 2-year OS was 100% in study cohort.

Conclusions:

It has been reported that 4-year OS of DLBCL was 86% in low risk group (0-1 IPI factor) treated with R-CHOP. Favorable result with short course chemotherapy showed in our study despite short follow-up time. On the result, we suggest reduced treatment for localized DLBCL after complete resection. However, prospective study is warranted to investigate effectiveness.

Disclosures:

No relevant conflicts of interest to declare.

Topics:
adjuvant chemotherapy, diffuse large b-cell lymphoma, chemotherapy regimen, r-chop, cyclophosphamide, doxorubicin, prednisone, and vincristine, follow-up, adverse event, cyclophosphamide, doxorubicin, gastrointestinal lymphoma

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2010 by The American Society of Hematology
2010
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