Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma : a LYSA study
© 2021 by The American Society of Hematology..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
|---|---|
| Enthalten in: |
Blood advances - 5(2021), 19 vom: 12. Okt., Seite 3862-3872 |
| Sprache: |
Englisch |
|---|
| Links: |
|---|
| Themen: |
Antibodies, Monoclonal, Murine-Derived |
|---|
| Anmerkungen: |
Date Completed 01.11.2021 Date Revised 16.07.2022 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1182/bloodadvances.2021004778 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM33004396X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM33004396X | ||
| 003 | DE-627 | ||
| 005 | 20231225210438.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1182/bloodadvances.2021004778 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1100.xml |
| 035 | |a (DE-627)NLM33004396X | ||
| 035 | |a (NLM)34461634 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Camus, Vincent |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma |b a LYSA study |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.11.2021 | ||
| 500 | |a Date Revised 16.07.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 by The American Society of Hematology. | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Antibodies, Monoclonal, Murine-Derived |2 NLM | |
| 700 | 1 | |a Rossi, Cédric |e verfasserin |4 aut | |
| 700 | 1 | |a Sesques, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Lequesne, Justine |e verfasserin |4 aut | |
| 700 | 1 | |a Tonnelet, David |e verfasserin |4 aut | |
| 700 | 1 | |a Haioun, Corinne |e verfasserin |4 aut | |
| 700 | 1 | |a Durot, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Willaume, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Gauthier, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Moles-Moreau, Marie-Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Antier, Chloé |e verfasserin |4 aut | |
| 700 | 1 | |a Lazarovici, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Monjanel, Hélène |e verfasserin |4 aut | |
| 700 | 1 | |a Bernard, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Tardy, Magalie |e verfasserin |4 aut | |
| 700 | 1 | |a Besson, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Lebras, Laure |e verfasserin |4 aut | |
| 700 | 1 | |a Choquet, Sylvain |e verfasserin |4 aut | |
| 700 | 1 | |a Le Du, Katell |e verfasserin |4 aut | |
| 700 | 1 | |a Bonnet, Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Bailly, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Damaj, Ghandi |e verfasserin |4 aut | |
| 700 | 1 | |a Laribi, Kamel |e verfasserin |4 aut | |
| 700 | 1 | |a Maisonneuve, Hervé |e verfasserin |4 aut | |
| 700 | 1 | |a Houot, Roch |e verfasserin |4 aut | |
| 700 | 1 | |a Chauchet, Adrien |e verfasserin |4 aut | |
| 700 | 1 | |a Jardin, Fabrice |e verfasserin |4 aut | |
| 700 | 1 | |a Traverse-Glehen, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Decazes, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Becker, Stéphanie |e verfasserin |4 aut | |
| 700 | 1 | |a Berriolo-Riedinger, Alina |e verfasserin |4 aut | |
| 700 | 1 | |a Tilly, Hervé |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Blood advances |d 2016 |g 5(2021), 19 vom: 12. Okt., Seite 3862-3872 |w (DE-627)NLM268683263 |x 2473-9537 |7 nnns |
| 773 | 1 | 8 | |g volume:5 |g year:2021 |g number:19 |g day:12 |g month:10 |g pages:3862-3872 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1182/bloodadvances.2021004778 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 5 |j 2021 |e 19 |b 12 |c 10 |h 3862-3872 | ||