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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
- Source :
- Leukemialymphoma. 56(1)
- Publication Year :
- 2014
-
Abstract
- We have studied the feasibility and efficacy of intensified R-MegaCHOP-ESHAP-BEAM therapy in high-risk aggressive B-cell lymphomas. Altogether 105 patients (19-64 years) with diffuse 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 high-dose 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 patients45 years having PFS 54%. PMBL had better prognosis than DLBCL/FL3 in patients45 years (PFS, 88% vs. 48%), but not in younger patients (PFS, 91% vs. 94%).
- Subjects :
- Melphalan
Oncology
Male
Cancer Research
Antibodies, Monoclonal, Murine-Derived
International Prognostic Index
immune system diseases
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
Neoplasm Metastasis
Etoposide
Podophyllotoxin
Cytarabine
Hematology
Induction Chemotherapy
Middle Aged
Prognosis
3. Good health
Treatment Outcome
Vincristine
Disease Progression
Rituximab
Female
medicine.drug
Adult
medicine.medical_specialty
Lymphoma, B-Cell
Methylprednisolone
Young Adult
Internal medicine
medicine
Humans
Cyclophosphamide
Neoplasm Staging
business.industry
medicine.disease
Carmustine
Lymphoma
Surgery
Consolidation Chemotherapy
Doxorubicin
Prednisone
Cisplatin
business
ESHAP
Subjects
Details
- ISSN :
- 10292403
- Volume :
- 56
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Leukemialymphoma
- Accession number :
- edsair.doi.dedup.....5765ce6d019f683ec6b1d0de39a664ef