Phase II Trial of R-CHOP Vs CHOP Chemotherapy in Pakistani Diffuse Large B cell Lymphoma Patients

Objective: To determine response and relapse rates in diffuse large B cell lymphoma (DLBCL) patients receiving rituximab, cyclophosphamide, adriamycin, vincristine and prednisolone (R-CHOP) versus cyclophosphamide, adriamycin, vincristine and prednisolone (CHOP). Study Design: RC T (Randomized Control Trial). Materials and Methods: This Randomized Control Trial was conducted between April 2007 and December 2008. 119 newly diagnosed consecutive DLBCL patients were treated with either R-CHOP or CHOP as first line chemotherapy at the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH RC), Lahore, Pakistan. The CHOP chemotherapy was offered to 63 patients (53%) and 56 patients (47%) were given R-CHOP therapy. The arms were balanced with respect to International Prognostic Index (IPI) score, stage, and B symptoms (presence of systemic complaints of fever, weight loss, or night sweats). Results: The response rates in terms of (disappearance of all radiological or biological lesions at the time of initial diagnosis and the absence of new lesions) were 48 % vs. 44% (p= 0.715) in R-CHOP and CHOP groups, respectively. Whereas the relapse rates were 9% vs. 20% (p=0.04) in R-CHOP and CHOP groups, respectively. Conclusion: The addition of rituximab to CHOP chemotherapy increased the event free interval compared to CHOP chemotherapy in DLBCL Pakistani patients. However, it did not show any influence in response rate in this population.