Primary mediastinal B‐cell lymphoma with sclerosis: Report of 11 cases treated with intensified‐CHOP plus radiotherapy

Abstract

Primary mediastinal B-cell lymphoma (PMBCL) is a clinicopathological entity with aggressive behavior. Retrospective evaluation suggests the need for intensive chemotherapy programs. From 1997 to February 2003, a total of 11 cases of previously untreated PMBCL with sclerosis were treated at our institution with 5 courses of intensified CHOP (ICHOP) regimen and mediastinal irradiation. Three patients were submitted to high-dose chemotherapy with peripheral-blood stem-cell support, followed by radiotherapy, because of intermediate-risk age-adjusted International Prognostic Index at diagnosis. After a median follow up of 30 months, all patients but one are in continuous complete remission (CR), and overall survival is 100%. Am.

Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone with or Without Radiotherapy in Primary Mediastinal Large B-Cell Lymphoma: The Emerging Standard of Care

“…Other investigators have reported results that compare favorably with those of CHOP, using various intensive regimens [8,11,12]. However, the use of any particular approach is not supported by randomized trials.…”

Primary mediastinal B‐cell lymphoma in the pediatric patient: Can a rational approach to therapy be based on adult studies?

“…In a multi‐center study of 138 patients, Todeschini et al 21 used IFRT in initial treatment and showed that this approach significantly improved outcome regardless of the type of chemotherapy (5‐year EFS approximately 92% with IFRT, 78% without IFRT). Similarly, several multinational, retrospective reviews showed that among patients who achieved a PR after induction chemotherapy, RT was able to produce a CR in the majority 23, 24, 33.In Mazzarotto's study 42% of patients were in CR after the chemotherapy and 95% after the addition of IFRT, at a mean dose of 36Gy in 22 fractions. The 5‐year DFS and OS were 93% and 87% respectively 24.…”