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Although survival of patients with diffuse large B-cell lymphoma (DLBCL) has improved in the rituximab (R) era, those with high-risk or high-intermediate–risk International Prognostic Index scores (IPI 2–3) have poorer outcomes with standard R-chemotherapy than those with lower-risk IPI scores.
To test the benefit of high-dose therapy followed by autologous stem cell transplant (ASCT) consolidation in this setting, investigators in Italy conducted a multicenter, randomized, phase III trial comparing R plus high-dose sequential chemotherapy (R-HDS) and ASCT versus eight cycles of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-14 in 235 high-risk and high-intermediate–risk DLBCL patients (median age, 51 years).
At median fo…