R2CHOP reduces CNS relapse in diffuse large B-cell lymphoma
Adding lenalidomide to the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone; R2CHOP) frontline therapy for diffuse large B-cell lymphoma (DLBCL) reduces the rate of central nervous system (CNS) relapse, according to a recent study.
Accessing records from two R2CHOP trials, researchers grouped 136 DLBCL patients into three groups of low (n=14; median age 56.5 years), intermediate (n=97; median age 69 years) and high (n=25; median age 69 years) risk of CNS relapse. The Kaplan-Meier method was used to estimate relapse rates, which were then compared among groups.
Only one of the participants developed isolated CNS relapse, yielding an incidence rate of 0.7 percent. The time to relapse was 10 months and the event occurred 6 months after a complete treatment response was achieved. The participant belonged to the high-risk group.
The Kaplan-Meier estimate for the 2-year relapse rate was 0.9 percent for the entire R2CHOP cohort. The corresponding values for the low-, intermediate- and high-risk groups were 0, 0 and 5.0 percent. Compared with database patients treated with R-CHOP only, the 2-year CNS relapse rate for R2CHOP was lower (0.9 percent vs 1.8 percent).
The same was true for the low- (0 percent vs 1.4 percent) and intermediate- (0 percent vs 2.2 percent) risk groups, but not the high-risk patients (5.0 percent vs 1.1 percent).
The findings support further studies on the value of lenalidomide in decreasing CNS relapse in DLBCL patients, said researchers, noting that involving clinical and molecular factors in patient risk stratification may be an effective approach.