The effect of biweekly CHOP and standard CHOP in different subgroups of diffuse large B-cell lymphoma.

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. Conventional chemotherapy (CHOP: cyclophosphamide, doxorubicin, vincristine, prednisone) seems unsatisfactory, so modifications of CHOP are used to improve the efficacy. DLBCL is a highly variable tumor, with different responses to therapy. The aim of this study is to explore the association between immunophenotype and treatment response.

Patients And Methods: We analyzed the expression of Bcl-6, CD10, and MUM1 in 130 cases of DLBCL using immunohistochemistry. The cases were subdivided into germinal center B-cell-like (GCB) and non-GCB subtypes, and were randomly assigned to receive either 6-8 cycles of CHOP every 2 weeks or standard CHOP every 3 weeks.

Results: After a median followup duration of 40 months, 3-year overall survival of biweekly CHOP was better than standard CHOP in the non-GCB group (58.3 vs. 38.6%, p < 0.05). However, the therapeutic effect of biweekly CHOP and standard CHOP was not different in the GCB group (64.8 vs. 57.5%, p > 0.05).

Conclusions: Immunohistochemistry analysis of different subgroups is useful to find the suitable therapy. Biweekly CHOP showed higher efficacy than standard treatment in the non-GCB subgroup.