Una revisión sistemática y meta-análisis de rituximab basado en inmunoterapia para los subtipos de linfoma difuso de células B grandes.

Addition of rituximab to chemotherapy (R-chemo) has been shown to improve overall survival (OS) in patients with diffuse large B cell lymphoma (DLBCL). Germinal center B cell-like (GCB) subtype of DLBCL has a significantly better clinical outcome than those with non-germinal center B cell-like (non-GCB) subtype. Further research is needed to confirm this difference between those two subtypes treated with R-chemo. We searched for randomized controlled trials that compared R-chemo with identical chemotherapy alone in patients with newly diagnosed or relapsed DLBCL. A random versus fixed effects model was selected according to heterogeneity. Six eligible trials involving 748 adult patients were included in this meta-analysis. Fixed-effects analysis showed OS to be superior for the GCB patients treated with R-chemo (relative risk (RR)∈=∈1.16, 95% confidence interval (CI)∈=∈1.03-1.31, P∈=∈0.02). Superiority was also observed for the GCB subtype under R-chemo with respect to disease control (RR∈=∈1.16, 95% CI∈=∈0.99-1.36) and overall response (RR∈=∈1.19, 95% CI∈=∈0.99-1.99). Both subtypes showed an increased OS (RR∈=∈1.30, 95% CI∈=∈1.11-1.51; RR∈=∈1.89, 95% CI∈=∈1.52-2.35, respectively) and disease control rate (RR∈=∈1.27, 95% CI∈=∈1.05-1.54, P∈=∈0.01; RR∈=∈2.21, 95% CI∈=∈1.68-2.90, respectively) following R-chemo. Therefore, treated with R-chemo, GCB patients still has a significantly better clinical outcome than those with non-GCB subtype. © 2010 Springer-Verlag.