MACOP-B and Involved-Field Radiotherapy Is an Effective and Safe Therapy for Primary Mediastinal Large B Cell Lymphoma

Sanctis, Vitaliana De; Finolezzi, Erica; Osti, Mattia Falchetto; Grapulin, Lavinia; Alfó, Marco; Pescarmona, Edoardo; Berardi, F; Natalino, Fiammetta; Moleti, Maria Luisa; Rocco, Alice Di; Enrici, Riccardo Maurizi; Foà, Robin; Martelli, Maurizio

doi:10.1016/j.ijrobp.2008.02.036

Cited by 40 publications

(20 citation statements)

References 29 publications

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“…42 The age-adjusted IPI has generally been reported to be of limited predictive value, [43][44][45] although in a recent series of 92 patients there was some clear discriminative value. 46 Elevation of LDH to greater than twice the upper limit of normal, age over 40 and performance status ≥ 2 all correlated with reduced survival in a population-based series from British Columbia, 43 while in a large series from the International Extranodal Lymphoma Study Group (IELSG) male sex, poor performance status and advancedstage disease were significant negative predictors of survival. 47 …”

Section: Prognostic Factorsmentioning

confidence: 96%

Primary Mediastinal B-Cell Lymphoma

Johnson¹,

Davies²

2008

Hematology

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Primary mediastinal B-cell lymphoma is a discrete clinicopathologic entity. Molecular analysis reveals it to be distinct from other types of large B-cell lymphoma, and retrospective analysis suggests that it may respond better to multi-agent chemotherapy regimens than to the more commonly used CHOP. The addition of rituximab may mitigate such differences, and may also diminish the role of consolidation radiotherapy, which is often used to treat residual mediastinal masses. For the future the role of FDG-PET scanning requires prospective examination, and it is hoped that this may allow the de-escalation of treatment if it can be shown to yield reliable prognostic information. The relative rarity of this type of lymphoma necessitates international collaboration in clinical trials, with a prospective clinicopathologic study, IELSG 26, already underway.

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Section: Prognostic Factorsmentioning

confidence: 96%

Primary Mediastinal B-Cell Lymphoma

Johnson¹,

Davies²

2008

Hematology

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“…349 In retrospective analyses, intensive chemotherapy regimens have been more effective than CHOP, [350][351][352] and the addition of IFRT improved outcomes. 353,354 The role of RT must be confirmed in randomized trials. In a retrospective study, the addition of rituximab to MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin) or VACOP-B (etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin) did not seem to result in significant differences in clinical outcomes.…”

Section: Pmblmentioning

confidence: 99%

Non-Hodgkin's Lymphomas

Zelenetz

Abramson

Advani

et al. 2011

J Natl Compr Canc Netw

164

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OverviewNon-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B-, T-, or natural killer (NK) lymphocytes. In the United States, B-cell lymphomas represent 80% to 85% of the cases, with 15% to 20% being Tcell lymphomas; NK lymphomas are rare. In 2010, an estimated 65,540 new cases of NHL were diagnosed and 20,210 patients died of the disease.1 NHL is the sixth leading site of new cancer diagnoses among men and women, accounting for 4% of new cancer cases and 4% of cancer-related deaths.

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“…The 5-year OS and PFS rates were 87 and 81%, respectively. This study showed that MACOP-B and IFRT induced high response and lymphoma-free survival rates (10). In the present study, RT was associated with significantly improved PFS and OS rates compared with patients without RT, and furthermore, the analysis performed on patients who achieved more than PD following chemotherapy showed that RT was associated with a significantly improved 5-year OS rate and exhibited a trend for an improved 5-year PFS rate, which is similar to the results of the aforementioned studies.…”

Section: Discussionmentioning

confidence: 64%

“…The cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen is considered to be inferior to other more intensive regimens (6)(7)(8)(9)(10), such as the methotrexate, cytarabine, cyclophosphamide, vincristine, prednisone and bleomycin regimen (MACOP-B), dose-dense regimens, or even front-line consolidation high-dose therapy and autologous stem cell transplantation. However, none of these intensified approaches is now expected to provide results superior to those observed with rituximab plus CHOP (RCHOP).…”

Section: Introductionmentioning

confidence: 99%

Role of radiotherapy in the treatment of primary mediastinal large B-cell lymphoma

Wang

Liu

et al. 2015

Oncology Letters

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Abstract. The role of radiotherapy (RT) in the treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is unclear. In the present study, a retrospective analysis of 63 patients with PMLBCL treated with or without RT was performed to evaluate the role of RT. Clinical outcomes were calculated using the Kaplan-Meier method and were compared between patients who did and did not receive RT, using the log-rank test. A multivariate analysis was performed using Cox proportional hazards model. After chemotherapy, 35 patients received RT, and RT was found to be associated with significantly improved 5-year overall survival (OS) (87 vs. 58%; P=0.001) and 5-year progression-free survival (PFS) (75 vs. 39%; P=0.001) rates compared with patients without RT. The subgroup analysis on 35 patients who received rituximab plus chemotherapy showed that RT did not improve the 5-year OS (88 vs. 92%; P=0.814) or the 5-year PFS (78 vs. 65%; P=0.511) rates compared with patients without RT. On multivariate analysis, RT and the addition of rituximab were predictive of increased OS [RT: Hazard ratio (HR), 0.157; P=0.018; rituximab: HR, 0.156; P=0.009] and PFS (RT: HR 0.111, P=0.001; Rituximab: HR 0.231, P=0.002) rates. However, the role of RT in PMLBCL in the rituximab era is unclear. Further investigation of the role of RT in the era of targeted therapy is required.

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MACOP-B and Involved-Field Radiotherapy Is an Effective and Safe Therapy for Primary Mediastinal Large B Cell Lymphoma

Cited by 40 publications

References 29 publications

Primary Mediastinal B-Cell Lymphoma

Primary Mediastinal B-Cell Lymphoma

Non-Hodgkin's Lymphomas

Role of radiotherapy in the treatment of primary mediastinal large B-cell lymphoma

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