Dose escalated CHOP + etoposide and repetitive autologous stem cell transplantation (MegaCHOEP) with and without rituximab for primary treatment of aggressive NHL

Abstract

6654 Background: The role of high dose chemotherapy (HDT) +/- Rituximab (R) in primary treatment of aggressive NHL is still controversial. Methods: Patients at an age of 18 to 60 years and elevated LDH at diagnosis received 4 courses of dose escalated CHOP + Etoposide +/- R(MegaCHOEP) in a dose escalation trial (primary endpoint: time to treatment failure). Cycles 2 to 4 were followed by autologous SCT. At dose level 3 (DL3) cumulative doses of drugs were as follows: C 19.5 g/m2, H 280 mg/m2, O 8 mg, E 5.04 g/m2 P 2000 mg. In a further step, six cycles of rituximab (375 mg/m2) were added: one dose of R prior to each cycle of chemotherapy and two additional doses 3 and 6 weeks after the last cycle of chemotherapy, respectively. Results: From July 1999 to February 2003, 51 pts were enrolled at DL3, and 89 pts were enrolled at DL3R. There was a higher percentage of pts with ECOG performance status > 1 at DL3 (42.9%) than at DL3R (19.7%, p = 0.012) and with IPI high risk at DL3 (34.3%) than at DL3R (12.7%, p ...