Literature DB >> 33754004

R-split-EPOCH plus high dose methotrexate in untreated diffuse large B cell lymphoma with MYC rearrangement or double expression of MYC and BCL-2.

Peng Sun1,2, Yu Wang1,2, Cui Chen3, Hang Yang1,2, Man Nie1,2, Xiao-Qing Sun1,2, Xiao-Hua He1,2, Wen-Qi Jiang1,2, Zhi-Ming Li1,2.   

Abstract

Purpose: Diffuse large B cell lymphoma (DLBCL) with MYC rearrangement or double expression of MYC and BCL-2 (DE DLBCL) has a relatively poor prognosis and does not respond well to standard R-CHOP. In the current study, we aimed to investigate the efficacy and safety of R-split-EPOCH plus high dose methotrexate (HD-MTX) in the particular patient population.
Methods: A total of 28 patients diagnosed with DE DLBCL or DLBCL with MYC rearrangement between January 2015 and December 2018 were included and retrospectively analyzed. All the participants underwent R-split-EPOCH plus HD-MTX as introduction therapy, with split infusion of etoposide, doxorubicin, and vincristine for 48 hours on D1-2 and D10-11, respectively.
Results: The overall objective response (ORR) rate was 100%, with 24 (85.7%) complete response (CR) and 4 (14.3%) partial response (PR). The CR rate was 76.9% and 93.3% for DLBCL patients with MYC rearrangement and DE DLBCL patients, respectively. The 1- and 3-year PFS rate was 100% and 74.9%, respectively. The 1- and 3-year OS rate was 100% and 92.9%, respectively. Grade 3/4 non-hematological toxicity and grade 3/4 hematological toxicity occurred in 50% and 85.7% of patients, respectively. No treatment-related death was reported. Conclusions: R-split-EPOCH plus HD-MTX regimen is an effective and feasible treatment option for DE DLBCL and DLBCL with MYC rearrangement. © The author(s).

Entities:  

Keywords:  MYC; R-split-EPOCH; diffuse large B cell lymphoma (DLBCL); double expression; high dose methotrexate (HD-MTX)

Year:  2021        PMID： 33754004      PMCID： PMC7974535          DOI： 10.7150/jca.52958

Source DB:  PubMed          Journal:  J Cancer        ISSN： 1837-9664            Impact factor:   4.207


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