Six RCTs (n=748 patients) were included in the review. Follow-up periods ranged from 16 to 76 months.
In patients who received combined rituximab plus chemotherapy, the germinal centre B cell-like (GCB) subtype group had a significantly better overall survival than the non-GCB group (RR 1.16, 95% CI 1.03 to 1.31; I2=0%; five RCTs, n=323 patients), although differences in disease control rates (five RCTs) and overall response (three RCTs) did not reach statistical significance.
Patients who received combined rituximab plus chemotherapy had significantly improved overall survival (GCB subtype RR 1.30, 95% CI 1.11 to 1.51; I2=60%; four RCTs, n=286 patients: non-GCB subtype RR 1.89, 95% CI 1.52 to 2.35; I2=0%; four RCTs, n=328 patients) and disease control rate (GCB subtype RR 1.27, 95% CI 1.05 to 1.54; I2=0%; four RCTs: non-GCB subtype RR 2.21, 95% CI 1.68 to 2.90; I2=0%; , four RCTs) than patients who received chemotherapy alone.
The published forest plots indicated that all results were in the opposite direction to those reported by the authors.