| Literature DB >> 34461634 |
Vincent Camus1, Cédric Rossi2, Pierre Sesques3, Justine Lequesne4, David Tonnelet5, Corinne Haioun6, Eric Durot7, Alexandre Willaume8, Martin Gauthier9, Marie-Pierre Moles-Moreau10, Chloé Antier11, Julien Lazarovici12, Hélène Monjanel13,14, Sophie Bernard15, Magalie Tardy16, Caroline Besson17, Laure Lebras18, Sylvain Choquet19, Katell Le Du20, Christophe Bonnet21, Sarah Bailly22, Ghandi Damaj23, Kamel Laribi24, Hervé Maisonneuve25, Roch Houot26, Adrien Chauchet27, Fabrice Jardin1, Alexandra Traverse-Glehen28, Pierre Decazes5, Stéphanie Becker5, Alina Berriolo-Riedinger29, Hervé Tilly1.
Abstract
Primary mediastinal B-cell lymphoma (PMBL) is a rare type of aggressive lymphoma typically affecting young female patients. The first-line standard of care remains debated. We performed a large multicenter retrospective study in 25 centers in France and Belgium to describe PMBL patient outcomes after first-line treatment in real-life settings. A total of 313 patients were enrolled and received rituximab (R) plus ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) (n = 180) or CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) delivered every 14 days (R-CHOP14, n = 76) or 21 days (R-CHOP21, n = 57) and consolidation strategies in modalities that varied according to time and institution, mainly guided by positron emission tomography. Consolidation autologous stem cell transplantation was performed for 46 (25.6%), 24 (31.6%), and 1 (1.8%) patient in the R-ACVBP, R-CHOP14, and R-CHOP21 groups, respectively (P < .001); only 17 (5.4%) patients received mediastinal radiotherapy. The end-of-treatment complete metabolic response rates were 86.3%, 86.8%, and 76.6% (P = .23) in the R-ACVBP, R-CHOP14, and R-CHOP21 groups. The median follow-up was 44 months, and the R-ACVBP, R-CHOP14, and R-CHOP21 three-year progression-free survival probabilities were 89.4% (95% confidence interval [CI], 84.8-94.2), 89.4% (95% CI, 82.7-96.6), and 74.7% (95% CI, 64-87.1) (P = .018). A baseline total metabolic tumor volume (TMTV) ≥360 cm3 was associated with a lower progression-free survival (hazard ratio, 2.18; 95% CI, 1.05-4.53). Excess febrile neutropenia (24.4% vs 5.3% vs 5.3%; P < .001) and mucositis (22.8% vs 3.9% vs 1.8%; P < .001) were observed with R-ACVBP compared with the R-CHOP regimens. Patients with PMBL treated with dose-dense immunochemotherapy without radiotherapy have excellent outcomes. R-ACVBP acute toxicity was higher than that of R-CHOP14. Our data confirmed the prognostic importance of baseline TMTV.Entities:
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Year: 2021 PMID： 34461634 PMCID： PMC8679665 DOI： 10.1182/bloodadvances.2021004778
Source DB: PubMed Journal: Blood Adv ISSN： 2473-9529