TY - JOUR
AR - IJCST-2022-4-102
TI - Early Primary Gastric Lymphoma with Adverse Prognosis Factors. Is it Benefit Adding Rituximab to CHOP-14?
AU - Agustin, Aviles
AU - Sergio, Cleto
JO - International Journal of Cancer Science and Therapy
PY - 2022
DA - Tue 18, Oct 2022
SN - 
DO - http://dx.doi.org/10.31487/j.IJCST.2022.04.02
UR - https://www.sciencerepository.org/early-primary-gastric-lymphoma_IJCST-2022-4-102 
KW - Diffuse large B-cell, primary gastric lymphoma, prognostic factors, dose dense chemotherapy, rituximab
AB - Objective: Assess if the addition of rituximab to a dose-dense chemotherapy regimen in patients with primary gastric diffuse large B-cell lymphoma (PGL) in early stage, but, associated with worse prognostic factors.
Patients and Methods: Patients with pathological diagnosis of PGL and early stages, but, with elevated levels of beta 2 microglobulin and lactic dehydrogenase, age > 18 years age without upper limit, no gender differences, previously untreated, were recruit in an open label clinical trial, to received CHOP-14 (cyclophosphamide, vincristine, doxorubicin and prednisone, dose dense, every 14 days) and compare with patients that received R-CHOP14 (rituximab + CHOP-14).
Results: Between March 2011 to December 2016, 141 patients were taken entry to the study: no statistical differences were observed in clinical and laboratory characteristics. Complete response (CR) was observed in 68 out of 72 (94.4%) patients in the CHOP-R14, and 67 out of 69 (95.1%) patients in the CHOP14 regimen. Actuarial curves at 5-years show that progression-free survival (PFS) was 89% (95%Confidence Interval (CI) in the CHOP-R14, that did not have statistical differences in the CHOP-14 arm: 92% (95%CI: 83% -97%) (p 0.887); the overall survival were: 90% (95% CI:86%-97%) and 93.4% (95% CI: 86% to 97%) (p 0,665). Toxicities were severe granulocytopenia and infection-related, but no dead were observed. Until now, late toxicities as acute leukemia, second neoplasms and cardiac damage has not been observed.
Conclusion: The use of dose dense regimen (CHOP-14) confirm that is useful in the treatment of PGL associated to worse prognosis factors, the addition of rituximab did not show any benefit.