PURPOSE: To analyze outcome, prognostic factors, and toxicities in patients with diffuse large-cell lymphoma (DLCL) who received involved-field radiotherapy (IFRT) before high-dose chemotherapy with autologous stem-cell rescue (ASCR). PATIENTS AND METHODS: Between January 1990 and August 2006, 164 patients with relapsed or refractory DLCL received IFRT at Memorial Sloan-Kettering Cancer Center (New York, NY) before high-dose chemotherapy and ASCR. IFRT was delivered to involved sites measuring more than 5 cm or to sites with residual disease more than 2 cm. Radiotherapy was administered in 1.5-Gy fractions twice daily to a total dose of 30 Gy. Progression-free survival and overall survival were calculated, and short- and long-term toxicity was assessed according to National Cancer Institute Common Toxicity Criteria (version 2.0). Median follow-up was 60 months (range, 2 to 187 months). RESULTS: Two- and 5-year progression-free survival was 62% and 53%; 2- and 5-year overall survival was 67% and 58%, respectively. Sixty-seven patients relapsed; only 10 patients relapsed completely within the radiotherapy field. There were seven early treatment-related mortalities and 11 secondary cancers (including four myelodysplastic syndromes), one of which occurred within the IFRT site and five after total-body irradiation. CONCLUSION: Minimal treatment-related mortality and morbidity resulted from short, intensive, involved-field radiotherapy before high-dose chemotherapy and ASCR, which was incorporated into a salvage regimen for patients with relapsed/refractory DLCL. This chemoradiotherapy salvage regimen resulted in a low local relapse rate that could potentially translate into an improved total outcome.
PURPOSE: To analyze outcome, prognostic factors, and toxicities in patients with diffuse large-cell lymphoma (DLCL) who received involved-field radiotherapy (IFRT) before high-dose chemotherapy with autologous stem-cell rescue (ASCR). PATIENTS AND METHODS: Between January 1990 and August 2006, 164 patients with relapsed or refractory DLCL received IFRT at Memorial Sloan-Kettering Cancer Center (New York, NY) before high-dose chemotherapy and ASCR. IFRT was delivered to involved sites measuring more than 5 cm or to sites with residual disease more than 2 cm. Radiotherapy was administered in 1.5-Gy fractions twice daily to a total dose of 30 Gy. Progression-free survival and overall survival were calculated, and short- and long-term toxicity was assessed according to National Cancer Institute Common Toxicity Criteria (version 2.0). Median follow-up was 60 months (range, 2 to 187 months). RESULTS: Two- and 5-year progression-free survival was 62% and 53%; 2- and 5-year overall survival was 67% and 58%, respectively. Sixty-seven patients relapsed; only 10 patients relapsed completely within the radiotherapy field. There were seven early treatment-related mortalities and 11 secondary cancers (including four myelodysplastic syndromes), one of which occurred within the IFRT site and five after total-body irradiation. CONCLUSION: Minimal treatment-related mortality and morbidity resulted from short, intensive, involved-field radiotherapy before high-dose chemotherapy and ASCR, which was incorporated into a salvage regimen for patients with relapsed/refractory DLCL. This chemoradiotherapy salvage regimen resulted in a low local relapse rate that could potentially translate into an improved total outcome.
Authors: Craig S Sauter; Matthew J Matasar; Jessica Meikle; Heiko Schoder; Gary A Ulaner; Jocelyn C Migliacci; Patrick Hilden; Sean M Devlin; Andrew D Zelenetz; Craig H Moskowitz Journal: Blood Date: 2015-03-10 Impact factor: 22.113
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Authors: M Lia Palomba; Joachim Yahalom; Brandon S Imber; Michel Sadelain; Carl DeSelm; Connie Batlevi; Renier J Brentjens; Parastoo B Dahi; Sergio Giralt; Jae H Park; Craig Sauter; Michael Scordo; Gunjan Shah; Miguel-Angel Perales Journal: Br J Haematol Date: 2020-03-05 Impact factor: 6.998
Authors: Parastoo B Dahi; Roni Tamari; Sean M Devlin; Molly Maloy; Valkal Bhatt; Michael Scordo; Jenna Goldberg; Andrew D Zelenetz; Paul A Hamlin; Matthew J Matasar; Jocelyn Maragulia; Sergio A Giralt; Miguel-Angel Perales; Craig H Moskowitz; Craig S Sauter Journal: Biol Blood Marrow Transplant Date: 2014-08-28 Impact factor: 5.742