A retrospective analysis of outcomes for primary mediastinal large B-cell lymphoma treated with RCHOP followed by radiotherapy or front-line autologous stem cell transplantation.

Abstract

OBJECTIVES:

Our aim was to retrospectively investigate the data from our institute the response rate and outcome in patients with primary mediastinal B-cell lymphoma (PMBL) who received the rituximab in combination with CHOP (RCHOP) followed by autologous stem cell transplantation (ASCT) or RCHOP followed by involved field radiation therapy (IFRT).

METHODS:

Sixty five patients with PMBL received RCHOP as first-line chemotherapy between January 2005 and December 2010. Forty of the 65 patients completed the planned subsequent IFRT after initial chemotherapy. Thirteen of the 65 patients received the front-line ASCT after RCHOP. Twelve patients received RCHOP alone.

RESULTS:

Thirty two of the 40 patients who received the RCHOP followed by IFRT have complete remission (CR) or CRu (CR/unconfirmed). All patients have CR or CRu after the ASCT. The progression free survival (PFS) and the estimated overall survival (OS) rate at 5 years for 32 CR/CRu patients in the RCHOP followed by IFRT group were 57 and 65%, respectively, as compared to RCHOP/ASCT group who were 94 and 100%, respectively. Twelve patients who received RCHOP alone had the same PFS and OS rate as the 40 patients who received RCHOP/IFRT (5-year PFS:62 vs. 65%, p = 0.068; 5-year OS:57 vs. 67%, p = 0.058). For all 65 patients, the age-adjusted international prognostic index (aaIPI) score remained the only predictor of a worse outcome.

CONCLUSION:

The PFS and OS rate of RCHOP/IFRT were found to be unsatisfied. RCHOP/ASCT showed a satisfactory PFS and OS rate.

• Authors: Xiaojian Liu, Ting Deng, Xianzhi Guo, Ye Guo, Leiping Wang, Jian Zhang, Zuguang Xia, Quanling Zhang, Kai Xue, Junning Cao, Jumei Shi, Xiaonan Hong
• Journal: Hematology (Amsterdam, Netherlands) (Hematology) Vol. 22 Issue 5 Pg. 258-264 (Jun 2017) ISSN: 1607-8454 [Electronic] England
• PMID: 27884092 (Publication Type: Journal Article)

Chemical References

• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Autografts
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage)
• Disease-Free Survival
• Doxorubicin (administration & dosage, analogs & derivatives)
• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (mortality, therapy)
• Male
• Mediastinal Neoplasms (mortality, therapy)
• Middle Aged
• Prednisone (administration & dosage)
• Retrospective Studies
• Rituximab (administration & dosage)
• Stem Cell Transplantation
• Survival Rate
• Vincristine (administration & dosage)