BACKGROUND: Third-generation regimens (MACOP-B [methotrexate/leucovorin (LV)/doxorubicin/cyclophosphamide/vincristine/ prednisone/bleomycin] or VACOP-B [etoposide/LV/doxorubicin/cyclophosphamide/vincristine/prednisone/bleomycin]) in combination with local radiation therapy seem to improve lymphoma-free survival of primary mediastinal large B-cell lymphoma (PMLBCL). Recently, the superiority of R-CHOP (rituximab plus cyclophosphamide/doxorubicin/vincristine/ prednisone) over CHOP-like regimens has been demonstrated in elderly and younger patients with low-risk diffuse large B-cell lymphoma. PATIENTS AND METHODS: Retrospectively, between February 2002 and July 2006, 45 previously untreated patients with PMLBCL were treated with a combination of a third-generation chemotherapy regimen (MACOP-B or VACOP-B), concurrent rituximab, and mediastinal radiation therapy. RESULTS: Twenty-six (62%) patients achieved a complete response (CR), and 15 (36%) obtained a partial response after MACOP-B/VACOP-B plus rituximab. After radiation therapy, the CR rate was 80%. At a median follow-up of 28 months, among the 34 patients who obtained a CR, 3 relapsed after 16, 19, and 22 months, respectively. Projected overall survival was 80% at 5 years; the relapse-free survival (RFS) curve of the 34 patients who achieved CR was 88% at 5 years. CONCLUSION: In this retrospective study, in patients with PMLBCL, combined-modality treatment using the MACOP-B/VACOP-B regimen plus rituximab induces a high remission rate, with patients having a > 80% chance of surviving relapse free at 5 years. In comparison with historical data on MACOP-B/VACOP-B without rituximab, there are no statistically significant differences in terms of CR and RFS rates.
BACKGROUND: Third-generation regimens (MACOP-B [methotrexate/leucovorin (LV)/doxorubicin/cyclophosphamide/vincristine/ prednisone/bleomycin] or VACOP-B [etoposide/LV/doxorubicin/cyclophosphamide/vincristine/prednisone/bleomycin]) in combination with local radiation therapy seem to improve lymphoma-free survival of primary mediastinal large B-cell lymphoma (PMLBCL). Recently, the superiority of R-CHOP (rituximab plus cyclophosphamide/doxorubicin/vincristine/ prednisone) over CHOP-like regimens has been demonstrated in elderly and younger patients with low-risk diffuse large B-cell lymphoma. PATIENTS AND METHODS: Retrospectively, between February 2002 and July 2006, 45 previously untreated patients with PMLBCL were treated with a combination of a third-generation chemotherapy regimen (MACOP-B or VACOP-B), concurrent rituximab, and mediastinal radiation therapy. RESULTS: Twenty-six (62%) patients achieved a complete response (CR), and 15 (36%) obtained a partial response after MACOP-B/VACOP-B plus rituximab. After radiation therapy, the CR rate was 80%. At a median follow-up of 28 months, among the 34 patients who obtained a CR, 3 relapsed after 16, 19, and 22 months, respectively. Projected overall survival was 80% at 5 years; the relapse-free survival (RFS) curve of the 34 patients who achieved CR was 88% at 5 years. CONCLUSION: In this retrospective study, in patients with PMLBCL, combined-modality treatment using the MACOP-B/VACOP-B regimen plus rituximab induces a high remission rate, with patients having a > 80% chance of surviving relapse free at 5 years. In comparison with historical data on MACOP-B/VACOP-B without rituximab, there are no statistically significant differences in terms of CR and RFS rates.
Authors: Theodoros P Vassilakopoulos; Gerassimos A Pangalis; Andreas Katsigiannis; Sotirios G Papageorgiou; Nikos Constantinou; Evangelos Terpos; Alexandra Zorbala; Effimia Vrakidou; Panagiotis Repoussis; Christos Poziopoulos; Zacharoula Galani; Maria N Dimopoulou; Stella I Kokoris; Sotirios Sachanas; Christina Kalpadakis; Evagelia M Dimitriadou; Marina P Siakantaris; Marie-Christine Kyrtsonis; John Dervenoulas; Meletios A Dimopoulos; John Meletis; Paraskevi Roussou; Panayiotis Panayiotidis; Photis Beris; Maria K Angelopoulou Journal: Oncologist Date: 2012-01-26
Authors: Marcus Messmer; Hua-Ling Tsai; Ravi Varadhan; Lode J Swinnen; Richard J Jones; Richard F Ambinder; Satish P Shanbhag; Michael J Borowitz; Nina Wagner-Johnston Journal: Leuk Lymphoma Date: 2019-01-18
Authors: Chelsea C Pinnix; Bouthaina Dabaja; Mohamed Amin Ahmed; Hubert H Chuang; Colleen Costelloe; Christine F Wogan; Valerie Reed; Jorge E Romaguera; Sattva Neelapu; Yasuhiro Oki; M Alma Rodriguez; Luis Fayad; Frederick B Hagemeister; Loretta Nastoupil; Francesco Turturro; Nathan Fowler; Michelle A Fanale; Yago Nieto; Issa F Khouri; Sairah Ahmed; L Jeffrey Medeiros; Richard Eric Davis; Jason Westin Journal: Int J Radiat Oncol Biol Phys Date: 2015-05-01 Impact factor: 7.038
Authors: Pier Luigi Zinzani; Armando Santoro; Giuseppe Gritti; Pauline Brice; Paul M Barr; John Kuruvilla; David Cunningham; Justin Kline; Nathalie A Johnson; Neha Mehta-Shah; Thomas Manley; Stephen Francis; Manish Sharma; Alison J Moskowitz Journal: J Clin Oncol Date: 2019-08-09 Impact factor: 44.544