Primary mediastinal large B-cell lymphoma with sclerosis: a clinical study of 89 patients treated with MACOP-B chemotherapy and radiation therapy.

Abstract

BACKGROUND AND OBJECTIVES:

Primary mediastinal large B-cell lymphoma (PMLBCL) with sclerosis has recently been recognized as a specific clinical and pathologic entity for which the best therapeutic approach seems to be a combination of chemotherapy and radiotherapy.

DESIGN AND METHODS:

Between 1989 and 1998, 89 previously untreated patients with PMLBCL with sclerosis were treated with a combination of a third-generation chemotherapy regimen (MACOP-B) and mediastinal radiation therapy. The response evaluations were examined after chemotherapy and at the end of radiotherapy.

RESULTS:

Twenty-three (26%) patients achieved a complete response (CR) and 59 (66%) obtained a partial response (PR) after the MACOP-B regimen. After radiation therapy, 55/59 (93%) of the patients in PR achieved CR. The CR rate at the end of the treatment was 88% (78/89). Only 7 (8%) patients were non-responders. Among the 78 patients who obtained a CR there were 7 (9%) relapses in a median follow-up of 5 months (all relapses occurred within 9 months); the other 71 patients are currently in continuous CR with a median follow-upof 45 months (range, 4-110 months). Projected overall survival was 86% at 9 years; the relapse-free survival curve of the 78 patients who achieved CR was 91% at 9 years.

INTERPRETATION AND CONCLUSIONS:

In patients with PMLBCL with sclerosis, combined modality treatment using the MACOP-B chemotherapy regimen and radiation therapy induces a good remission rate with the patients having a greater than 90% chance of surviving disease-free at 9 years. Radiotherapy often plays a pivotal role in obtaining CR status.

• Authors: P L Zinzani, M Martelli, M Bendandi, A De Renzo, A Zaccaria, E Pavone, M Bocchia, B Falini, M Gobbi, F Gherlinzoni, V Stefoni, M Tani, S Tura
• Journal: Haematologica (Haematologica) Vol. 86 Issue 2 Pg. 187-91 (Feb 2001) ISSN: 0390-6078 [Print] Italy
• PMID: 11224489 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Bleomycin
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Leucovorin
• Prednisone
• Methotrexate

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, standards, therapeutic use)
• Bleomycin (administration & dosage, standards)
• Cyclophosphamide (administration & dosage, standards)
• Disease-Free Survival
• Doxorubicin (administration & dosage, standards)
• Female
• Humans
• Leucovorin (administration & dosage, standards)
• Lymphoma, B-Cell (drug therapy, pathology, radiotherapy)
• Lymphoma, Large B-Cell, Diffuse (drug therapy, pathology, radiotherapy)
• Male
• Mediastinal Neoplasms (drug therapy, pathology, radiotherapy)
• Methotrexate (administration & dosage, standards)
• Middle Aged
• Prednisone (administration & dosage, standards)
• Sclerosis
• Survival Rate
• Treatment Outcome
• Vincristine (administration & dosage, standards)