A single-institution retrospective analysis of outcomes for stage I–II primary mediastinal large B-cell lymphoma treated with immunochemotherapy with or without radiotherapy. Issue 3 (3rd March 2016)

• Record Type: Journal Article
• Authors: Binkley, Michael S.; Hiniker, Susan M.; Wu, Sharon; Natkunam, Yasodha; Mittra, Erik S.; Advani, Ranjana H.; Hoppe, Richard T.
• Is Part Of: Leukemia & lymphoma. Volume 57:Issue 3(2016:Mar.)
• Page Start: 604
• Page End: 608
• Publication Date: 2016-03-03
• Subjects: Primary mediastinal large B-cell lymphoma; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2015.1067700
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract : As the optimal treatment for primary mediastinal large B-cell lymphoma (PMBCL) remains undefined, we evaluated outcomes of patients treated with standard and dose-intense rituximab-chemotherapy (R-CT) with and without radiotherapy (RT). We retrospectively identified 28 patients with stage I–II PMBCL in our lymphoma database, re-reviewed pathology slides and scored interim or post-chemotherapy PET/CTs using the Deauville scale. Fourteen patients received RT (36–45 Gy) preceded by either six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or 12 weeks of rituximab, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin (R-VACOP-B) with median follow-up of 94 months. Fourteen patients received 4–8 cycles of dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and rituximab (DA-EPOCH-R) with median follow-up of 38 months; one of these received RT (36 Gy) due to post-chemotherapy PET/CT Deauville score 4. Following R-CT and RT or DA-EPOCH-R, 5-year and 3-year FFP and OS were both 100%. Both R-CHOP/R-VACOP-B with RT and DA-EPOCH-R demonstrate excellent outcomes.