Outcomes of adults and children with primary mediastinal B‐cell lymphoma treated with dose‐adjusted EPOCH ‐R
Year: 2017
Type: article
Study design: Observational Study
Abstract: Treatment with dose-adjusted EPOCH (etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone) chemotherapy and rituximab (DA-EPOCH-R) has become the standard of care for primary mediastinal B-cell lymphoma (PMBCL) at many institutions despite limited data in the multi-centre setting. We report a large, multi-centre retrospective analysis of children and adults with PMBCL treated with DA-EPOCH-R to characterize outcomes and evaluate prognostic factors. We assessed 156 patients with PMBCL treated with DA-EPOCH-R across 24 academic centres, including 38 children and 118 adults. All patients received at least one cycle of DA-EPOCH-R. Radiation therapy was administered in 14·9% of patients. With median follow-up of 22·6 months, the estimated 3-year event-free survival (EFS) was 85·9% [95% confidence interval (CI) 80·3-91·5] and overall survival was 95·4% (95% CI 91·8-99·0). Outcomes were not statistically different between paediatric and adult patients. Thrombotic complications were reported in 28·2% of patients and were more common in paediatric patients (45·9% vs. 22·9%, P = 0·011). Seventy-five per cent of patients had a negative fluorodeoxyglucose positron emission tomography (FDG-PET) scan at the completion of DA-EPOCH-R, defined as Deauville score 1-3. Negative FDG-PET at end-of-therapy was associated with improved EFS (95·4% vs. 54·9%, P < 0·001). Our data support the use of DA-EPOCH-R for the treatment of PMBCL in children and adults. Patients with a positive end-of-therapy FDG-PET scan have an inferior outcome.
Source: British Journal of Haematology
DOI: 10.1111/bjh.14951
Authors: Lisa Giulino‐Roth, Tara O'Donohue, Zhengming Chen, Nancy L. Bartlett, Ann LaCasce, William Martin‐Doyle, Matthew J. Barth, Kimberly Davies, Kristie A. Blum, Beth Christian, Carla Casulo, Sonali M. Smith, James Godfrey, Amanda Termuhlen, Matthew J. Oberley, Sarah Alexander, Sheila Weitzman, Burton Appel, Benjamin Mizukawa, Jakub Svoboda, Zeinab Afify, Melinda Pauly, Hema Dave, Rebecca Gardner, Deborah M. Stephens, William A. Zeitler, Christopher Forlenza, Jennifer Levine, Michael E. Williams, Jody L. Sima, Catherine M. Bollard, John P. Leonard
Institutions: NewYork–Presbyterian Hospital, Weill Cornell Medicine, Weill Cornell Medical Center, Washington University in St. Louis, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Roswell Park Comprehensive Cancer Center, University at Buffalo, State University of New York, Boston Children's Hospital, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, University of Rochester Medicine, University of Rochester, University of Chicago, University of Southern California, Children's Hospital of Los Angeles, Hospital for Sick Children, Hackensack University Medical Center, Cincinnati Children's Hospital Medical Center, Abramson Cancer Center, University of Pennsylvania, University of Utah, Emory University, Children's Healthcare of Atlanta, Children's National, George Washington University, Seattle Children's Hospital, University of Washington, University of Iowa, Memorial Sloan Kettering Cancer Center, Columbia University Irving Medical Center, University of Virginia Medical Center, University of Virginia Cancer Center, University of Virginia, SUNY Upstate Medical University
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Award: G2768810539
OpenAlex ID: W2765486607