Clinical significance of rituximab infusion-related reaction in diffuse large B-cell lymphoma patients receiving R-CHOP

다국어 초록 (Multilingual Abstract)

Background/Aims: This study was to evaluate the clinical significance of infusion- related reaction (IRR) of rituximab in diffuse large B-cell lymphoma (DLBCL) patients who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) as a first-line chemotherapy.
Methods: The medical records of 326 patients diagnosed with DLBCL were re trospectively analyzed. Both doctor’s progress records and nursing records were reviewed. IRR was graded according to the National Cancer Institute Common Terminology Criteria.
Results: IRR was not associated with overall survival (OS) or progression-free survival (PFS) of DLBCL patients as compared to those who did not have IRR (OS: median 78.0 months vs. 69.0 months, p = 0.700; PFS: median 65.4 months vs. 64.0 months, p = 0.901). IRR grade did not affect OS or PFS. B symptoms was independently associated with IRR (hazard ratio [HR], 1.850; 95% confidence interval [CI], 1.041 to 3.290; p = 0.036). Further, bone marrow involvement was independently associated with re-IRR (HR, 4.904; 95% CI, 0.767 to 3.118; p = 0.029).
Conclusions: Our study shows that IRR of rituximab is not associated with OS or PFS of DLBCL patients who received R-CHOP. Furthermore, our study suggests a need for more careful observation for IRR in patients with B symptoms or bone marrow involvement.

참고문헌 (Reference)

• 1 Harris NL, "World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues : report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997" 17 : 3835-3849, 1999
• 2 Beers SA, "Type II(tositumomab)anti-CD20 monoclonal antibody out performs type I(rituximab-like)reagents in B-cell depletion regardless of complement activation" 112 : 4170-4177, 2008
• 3 Cheson BD, "Tumor lysis syndrome : an uncommon complication of fludarabine therapy of chronic lymphocytic leukemia" 16 : 2313-2320, 1998
• 4 Cartron G, "Therapeutic activity of humanized anti-CD20 monoclonal antibody and polymorphism in IgG Fc receptor FcgammaRIIIa gene" 99 : 754-758, 2002
• 5 Burger JA, "The microenvironment in mature B-cell malignancies : a target for new treatment strategies" 114 : 3367-3375, 2009
• 6 Alduaij W, "The future of anti-CD20 monoclonal antibodies: are we making progress?" 117 : 2993-3001, 2011
• 7 Campo E, "The 2008 WHO classification of lymphoid neoplasms and beyond : evolving concepts and practical applications" 117 : 5019-5032, 2011
• 8 Pfreundschuh M, "Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas : a randomised controlled trial(RICOVER-60)" 9 : 105-116, 2008
• 9 Habermann TM, "Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma" 24 : 3121-3127, 2006
• 10 Byrd JC, "Rituximab therapy in hematologic malignancy patients with circulating blood tumor cells : association with increased infusion-related side effects and rapid blood tumor clearance" 17 : 791-795, 1999
• 11 McLaughlin P, "Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma : half of patients respond to a four-dose treatment program" 16 : 2825-2833, 1998
• 12 Shibata-Koyama M, "Nonfucosylated rituximab potentiates human neutrophil phagocytosis through its high binding for FcgammaRIIIb and MHC class II expression on the phagocytotic neutrophils" 37 : 309-321, 2009
• 13 Armitage JO, "New approach to classifying non-Hodgkin’s lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin’s Lymphoma Classification Project" 16 : 2780-2795, 1998
• 14 Lenz HJ, "Management and preparedness for infusion and hypersensitivity reactions" 12 : 601-609, 2007
• 15 Sehn LH, "Introduction of combined CHOP plus rituximab therapy dramatically improved outcome of diffuse large B-cell lymphoma in British Columbia" 23 : 5027-5033, 2005
• 16 Sharma R, "Inflammatory(B)symptoms are independent predictors of myelosuppression from chemotherapy in Non-Hodgkin Lymphoma(NHL)patients : analysis of data from a British National Lymphoma Investigation phase III trial comparing CHOP to PMitCEBO" 9 : 153-, 2009
• 17 Lim LC, "Fatal cytokine release syndrome with chimeric anti-CD20 monoclonal antibody rituximab in a 71-year-old patient with chronic lymphocytic leukemia" 17 : 1962-1963, 1999
• 18 Winkler U, "Cytokine-release syndrome in patients with B-cell chronic lymphocytic leukemia and high lymphocyte counts after treatment with an anti-CD20 monoclonal antibody(rituximab, IDEC-C2B8)" 94 : 2217-2224, 1999
• 19 van der Kolk LE, "Complement activation plays a key role in the side-effects of rituximab treatment" 115 : 807-811, 2001
• 20 Yan Y, "Clinical and prognostic significance of bone marrow involvement in patients with diffuse aggressive B-cell lymphoma" 13 : 1336-1342, 1995
• 21 Pfreundschuh M, "CHOPlike chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma : a randomised controlled trial by the MabThera International Trial(MInT)Group" 7 : 379-391, 2006
• 22 Coiffier B, "CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma" 346 : 235-242, 2002
• 23 Legouffe E, "C-reactive protein serum level is a valuable and simple prognostic marker in non Hodgkin’s lymphoma" 31 : 351-357, 1998
• 24 Hong J, "Bone marrow involvement is predictive of infusion-related reaction during rituximab administration in patients with B cell lymphoma" 21 : 1145-1152, 2013
• 25 Harris NL, "A revised European-American classification of lymphoid neoplasms : a proposal from the International Lymphoma Study Group" 84 : 1361-1392, 1994
• 26 International Non-Hodgkin’s Lymphoma Prognostic Factors Project, "A predictive model for aggressive non-Hodgkin’s lymphoma" 329 : 987-994, 1993