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Treatment of high-risk aggressive B-cell non-Hodgkin lymphomas with rituximab, intensive induction and high-dose consolidation: long-term analysis of the R-MegaCHOP-ESHAP-BEAM Trial

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PYTLIK R. BELADA D. KUBACKOVA K. VÁŠOVÁ Ingrid KOZAK T. PIRNOS J. BOLOMSKA I. MATUSKA M. PRIBYLOVA J. CAMPR V. BUREŠOVÁ Lucie SYKOROVA A. BERKOVA A. KLENER P. TRNENY M.

Rok publikování 2015
Druh Článek v odborném periodiku
Časopis / Zdroj Leukemia and Lymphoma
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.3109/10428194.2014.904509
Obor Onkologie a hematologie
Klíčová slova Lymphomas; B cells; chemotherapy; immunotherapy; transplant
Popis We have studied the feasibility and efficacy of intensifi ed R-MegaCHOP-ESHAP-BEAM therapy in high-risk aggressive B-cell lymphomas. Altogether 105 patients (19 -64 years) with diff use large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBL) or follicular lymphoma grade 3 (FL3) with an age-adjusted International Prognostic Index of 2 -3 were recruited. Treatment consisted of three cycles of high-dose R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), followed by three cycles of R-ESHAP (rituximab, etoposide, methylprednisolone, cytarabine, cisplatin) and highdose consolidation with BEAM (BCNU, etoposide, cytarabine, melphalan) and autologous stem cell transplant. The 5-year progression-free survival (PFS) was 72% (DLBCL 60%, PMBL 89%) and overall survival (OS) was 74% (DLBCL 61%, PMBL 89%) after a median follow-up of 85 months. However, an independent prognostic factor was age only, with patients <= 45 years having 5-year PFS 90% and patients > 45 years having PFS 54%. PMBL had better prognosis than DLBCL/FL3 in patients > 45 years (PFS, 88% vs. 48%), but not in younger patients (PFS, 91% vs. 94%).

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