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. 2015 Oct 15;8(10):17515-22.
eCollection 2015.

Efficacy and safety of rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma: a meta-analysis

Fanlu Meng  1 , Diansheng Zhong  1 , Linlin Zhang  1 , Yi Shao  1 , Qing Ma  1
Affiliations

Efficacy and safety of rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma: a meta-analysis

Fanlu Meng et al. Int J Clin Exp Med. .

Abstract

The aim of this study is to systematically evaluate the safety and efficacy of rituximab plus CHOP (R-CHOP combined regimen) in patients with previously untreated diffuse large B cell lymphoma (DLBCL). Electronic database were searched for randomized-controlled studies only comparing R-CHOP to CHOP standard alone in patients with untreated DLBCL were included. The risk ratios (RRs) with their 95% corresponding intervals (95% CI) were employed to estimate the efficacy of overall response (OR), complete response (CR), risk of dying and relapse rate in followed-up period. Total ten case-control studies containing 2941 patients met the inclusion criteria. The addition of R to standard CHOP were showed to increase the proportion of CR (RR=1.23, 95% CI=1.13-1.35, P<0.00001) and OR (RR=1.39, 95% CI=1.24-1.55, P<0.00001) in a fixed-effect model, indicating that rituximab combined with CHOP regimen is efficacy than CHOP alone. It did not increase the overall risk of dying as a consequence of infection (RR=0.79, 95% CI=0.55-1.13, P=0.20). Furthermore, the relapse rates is significantly lower in R-CHOP (RR=0.52, 95% CI=0.38-0.71, P<0.0001). The adverse effects were also not significant (P>0.05). In summary, R-CHOP regimen is superior to standard CHOP in terms of overall response and complete response. It does not increase the incidence of adverse effects. However, more studies concerning different age groups and special patients are needed to discuss the potential role of R in DLBCL.

Keywords: CHOP; Diffuse large B-cell lymphoma; meta-analysis; rituximab.

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Figures

Figure 1
Figure 1
Flow chart demonstrating studies that were processed for inclusion in the meta-analysis.
Figure 2
Figure 2
Clinical outcome of complete response with R-CHOP compared with CHOP alone.
Figure 3
Figure 3
Forest plot for risk ratios of overall response with R-CHOP compared with CHOP alone.
Figure 4
Figure 4
Risk ratios of mortality with R-CHOP compared with CHOP alone.
Figure 5
Figure 5
Risk of relapse rate when comparing R-CHOP with CHOP alone.
Figure 6
Figure 6
Funnel plot analysis on the detection of publication bias in the meta-analysis.
See this image and copyright information in PMC

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