Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma: a LYSA study
| Autor: | Cédric Rossi, Kamel Laribi, Alexandra Traverse-Glehen, Fabrice Jardin, Roch Houot, Alexandre Willaume, Martin Gauthier, Sophie Bernard, David Tonnelet, Katell Le Du, Gandhi Damaj, Pierre Sesques, Magalie Pascale Tardy, Julien Lazarovici, Hélène Monjanel, Hervé Tilly, Laure Lebras, Corinne Haioun, Adrien Chauchet, Chloe Antier, Alina Berriolo-Riedinger, Caroline Besson, Herve Gerard Maisonneuve, Vincent Camus, Christophe Bonnet, Justine Lequesne, Eric Durot, Sylvain Choquet, Stéphanie Becker, Sarah Bailly, Marie-Pierre Moles-Moreau, Pierre Decazes |
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| Přispěvatelé: | UCL - SSS/DDUV/SIGN - Cell signalling, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service d'hématologie |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Vincristine medicine.medical_specialty Aggressive lymphoma CHOP Transplantation Autologous Antibodies Monoclonal Murine-Derived Autologous stem-cell transplantation Prednisone Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Retrospective Studies Lymphoid Neoplasia business.industry Hematopoietic Stem Cell Transplantation Hematology medicine.disease Treatment Outcome Vindesine Rituximab Female Primary mediastinal B-cell lymphoma Lymphoma Large B-Cell Diffuse business medicine.drug |
| Zdroj: | Blood Adv Blood advances, Vol. 5, no. 19, p. 3862-3872 (2021) |
| Popis: | Primary mediastinal B-cell lymphoma (PMBL) is a rare type of aggressive lymphoma typically affecting young female patients. The first-line standard of care remains debated. We performed a large multicenter retrospective study in 25 centers in France and Belgium to describe PMBL patient outcomes after first-line treatment in real-life settings. A total of 313 patients were enrolled and received rituximab (R) plus ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) (n = 180) or CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) delivered every 14 days (R-CHOP14, n = 76) or 21 days (R-CHOP21, n = 57) and consolidation strategies in modalities that varied according to time and institution, mainly guided by positron emission tomography. Consolidation autologous stem cell transplantation was performed for 46 (25.6%), 24 (31.6%), and 1 (1.8%) patient in the R-ACVBP, R-CHOP14, and R-CHOP21 groups, respectively (P < .001); only 17 (5.4%) patients received mediastinal radiotherapy. The end-of-treatment complete metabolic response rates were 86.3%, 86.8%, and 76.6% (P = .23) in the R-ACVBP, R-CHOP14, and R-CHOP21 groups. The median follow-up was 44 months, and the R-ACVBP, R-CHOP14, and R-CHOP21 three-year progression-free survival probabilities were 89.4% (95% confidence interval [CI], 84.8-94.2), 89.4% (95% CI, 82.7-96.6), and 74.7% (95% CI, 64-87.1) (P = .018). A baseline total metabolic tumor volume (TMTV) ≥360 cm3 was associated with a lower progression-free survival (hazard ratio, 2.18; 95% CI, 1.05-4.53). Excess febrile neutropenia (24.4% vs 5.3% vs 5.3%; P < .001) and mucositis (22.8% vs 3.9% vs 1.8%; P < .001) were observed with R-ACVBP compared with the R-CHOP regimens. Patients with PMBL treated with dose-dense immunochemotherapy without radiotherapy have excellent outcomes. R-ACVBP acute toxicity was higher than that of R-CHOP14. Our data confirmed the prognostic importance of baseline TMTV. |
| Databáze: | OpenAIRE |
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