A multi-center analysis of the impact of DA-EPOCH-R dose-adjustment on clinical outcomes of patients with double/triple-hit lymphoma

Cortese, Matthew J; Wei, Wei; Cerdena, Sebastian; Watkins, Marcus; Olson, Marissa; Jodon, Gray; Kaiser, Jeff; Haverkos, Bradley; Hughes, Mitchell E.; Namoglu, Esin C.; Grover, Natalie S; Snow, Anson; Orellana-Noia, Victor M.; Rainey, Magdalena A.; Sohail, Mohammad; Rudoni, Joslyn; Portell, Craig A.; Voorhees, Timothy J.; Landsburg, Daniel J.; Kamdar, Manali; Kahl, Brad S.; Hill, Brian T.

doi:10.1080/10428194.2022.2140281

Cited by 5 publications

(1 citation statement)

References 49 publications

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“…Nevertheless, the survival of DHL patients was unsurprisingly low and comparable to previous reports from the literature [2,19] while the survival of our DEL group was unexpectedly high. The PFS and OS rates of our DEL patients were, namely, in line with rates previously published from our center for a series of standard DLBCL patients treated with R-CHOP [20].…”

Section: Discussionsupporting

confidence: 89%

Do Double-Expressor High-Grade B-Cell Lymphomas Really Need Intensified Treatment? A Report from the Real-Life Series of High-Grade B-Cell Lymphomas Treated with Different Therapeutic Protocols at the Institute of Oncology Ljubljana

Boltežar,

Rožman,

Gašljević

et al. 2024

Biomedicines

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High-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements are known for their aggressive clinical course and so are the ones with MYC and BCL2 protein overexpression. The optimal therapy for these lymphomas remains to be elucidated. A retrospective analysis of all diffuse large B-cell lymphomas and high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements diagnosed between 2017 and 2021 at the Institute of Oncology Ljubljana, Slovenia, has been performed. Only patients with double-expressor lymphoma (DEL), double-hit lymphoma (DHL), or triple-hit lymphoma (THL) were included. Demographic and clinical parameters were assessed, as well as progression-free survival (PFS) and overall survival (OS). In total, 161 cases out of 309 (161/309; 52,1%) were classified as DEL. Sixteen patients had DHL, MYC/BCL2 rearrangement was observed in eleven patients, and MYC/BCL6 rearrangement was observed in five patients. Five patients were diagnosed with THL. Out of 154 patients (according to inclusion/exclusion criteria) included in further evaluation, one-hundred and thirty-five patients had double-expressor lymphoma (DEL), sixteen patients had DHL, and three patients had THL. In total, 169 patients were treated with R-CHOP, 10 with R-CHOP and intermediate-dose methotrexate, 19 with R-DA-EPOCH, and 16 with other regimens. The median follow-up was 22 months. The 5-year OS for the whole DEL group was 57.1% (95% CI 45.9–68.3%) and the 5-year PFS was 76.5% (95% CI 72.6–80.4%). The log-rank test disclosed no differences in survival between treatment groups (p = 0.712) while the high-risk international prognostic index (IPI) carried a significantly higher risk of death (HR 7.68, 95% CI 2.32–25.49, p = 0.001). The 5-year OS for DHL patients was 32.4% (95% CI 16.6–48.2%) while all three TH patients were deceased or lost to follow-up. Our analyses of real-life data disclose that the R-CHOP protocol with CNS prophylaxis is a successful and curative treatment for a substantial proportion of DEL patients.

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Section: Discussionsupporting

confidence: 89%