Clinical data and follow-up information were obtained by reviewing the patients’ medical records. All patients provided written informed consent for their treatment. Patient Characteristics We analyzed 100 newly diagnosed DLBL patients treated with initial R-CHOP chemotherapy. The clinical characteristics of all the patients are shown in Table this website 1. Median age of the patients was 60 years. Of the 100 patients, 45 were 61 years or older. Sixty-two patients had advanced-stage (stage III, IV) disease, and 23 patients had poor performance status (PS). In 52 patients, lactate dehydrogenase level (LDH) was high (over the upper limit of normal). Thirty-two patients had two or more

extranodal disease sites. Forty-two patients were in the higher IPI risk group (high or high-intermediate risk group). In 26 patients, serum albumin GDC-0449 cell line levels were < 3.5 g/dl. The median number of CHOP courses was 6 (range, 3–8). The median number of R-CHOP cycles for patients with localized disease was 6 (range, 3–8), and there was no significant difference in the number of cycles between patients with localized disease and those with advanced disease. Table 1 Patient characteristics   n. (%) Total number of patients 100

Age      < 61 55 (55)    ≥ 61 45 (45) Clinical Stage      I, II 38 (38)    III, IV 62 (62) Performance status      0–1 77 (77)    2–4 23 (23) LDH      N≥ 52 (52)    N < 48 (48) Extranodal lesion      0–1 68 (68)    2–4 32 (32) IPI      Low/low-intermediate 58 (58)    High/high-intermediate find more 42 (42) Albumin      < 3.5 g/dl 26 (26)    ≥3.5 g/dl 74 (74) Prophylactic G-CSF      yes 62 (62)    no 38 (38) N: normal range; IPI: international prognostic index; G-CSF: granulocyte colony-stimulating factor Chemotherapy Regimen The CHOP chemotherapy consisted of cyclophosphamide Protein kinase N1 (750 mg/m2 given intravenously on Day 1),

doxorubicin (50 mg/m2 given intravenously on Day 1), vincristine (1.4 mg/m2 (maximum 2 mg/body), given intravenously on Day 1) and prednisolone (100 mg/day, given orally on Day 1 to 5) [13]. The treatment course was repeated every three weeks, unless peripheral leukocyte or platelet counts became too low to administer the next cycle. A time limit for peripheral blood count recovery before administration of the next cycle of chemotherapy was not adopted. In patients who experienced severe neutropenia, thrombocytopenia and/or infections, or febrile neutropenia during cycles, the doses of cyclophosphamide, doxorubicin and vincristine in the subsequent cycle were reduced at the discretion of clinical physicians. Moreover, the dose of vincristine was also reduced depending on the occurrence and degree of neurologic toxicity. Rituximab was administered at a dose of 375 mg/m2 per cycle for up to 8 cycles concurrently with CHOP, as long as the disease responded to the treatment. Seven patients received involved-field radiation therapy of 30–40 Gy.