These factors were also separately analyzed in DLCL and MALT lymphoma by stratified log-rank test (Table 3).
The most common subtype in our study was DLCL followed by MALT.
Studies on the effectiveness of rituximab in gastric DLCL have revealed improvement in the response rate and survival [10, 34].
The coexistence of a low grade lymphoma with DLCL changes the prognosis because of the higher risk for a late relapse frequently instigated by the low grade component after eradication of the aggressive histology.
Although Ann Arbor stage is an important prognostic feature in DLCL, it is not the only pertinent one and is not the most important one either, as will be discussed in detail below.
A good example of this application is the discovery by Shipp et al of the overexpression of Protein Kinase C-b (PKC-b) in many cases of DLCL by using gene profiling techniques.
In cases of FL that transform into DLCL, the panel recommended chemotherapy with or without rituximab (Rituxan) as a treatment option.
Patients who have nonbulky (less than 10 cm) stage I or II DLCL and adverse risk factors now have the option of 6-8 cycles of a chemotherapy regimen consisting of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP).
DLCL patients who have nonbulky tumors but who do not have adverse risk factors can receive 3-4 cycles of CHOP with or without rituximab or locoregional radiation therapy.
The CHOP regimen, considered as a first generation combination, achieved a cure rate of approximately 3040 percent in patients with advanced stages of DLCL in national cooperative-group trials (2-3).
However many investigators refuse to accept that R-CHOP-14 is the gold standard for treatment of DLCL until a randomized study with a control arm of R-CHOP-21 is carried out.
Demographics of patient population Factor Result Median Age (range) 57(25-87) Diagnosis DLCL 49 FLCL 5 B cell 53 T cell 1 IPI 0-2 37 3-5 17 Ann Arbor Stage I-II 24 III 11 IV 19