[HTML][HTML] Dose-densified chemoimmunotherapy followed by systemic central nervous system prophylaxis for younger high-risk diffuse large B-cell/follicular grade 3 …
H Holte, S Leppä, M Björkholm, Ø Fluge, S Jyrkkiö… - Annals of oncology, 2013 - Elsevier
H Holte, S Leppä, M Björkholm, Ø Fluge, S Jyrkkiö, J Delabie, C Sundström…
Annals of oncology, 2013•ElsevierBackground Many patients with aggressive B-cell lymphomas and high clinical risk score
still die of lymphoma after conventional R-CHOP chemoimmunotherapy. We hypothesized
that intensified chemoimmunotherapy including systemic central nervous system (CNS)
prophylaxis improves outcome and reduces the incidence of CNS-related events. Patients
and methods Inclusion criteria were age 18–65 years, primary diffuse large B-cell lymphoma
or grade III follicular lymphoma without clinical signs of CNS disease and negative …
still die of lymphoma after conventional R-CHOP chemoimmunotherapy. We hypothesized
that intensified chemoimmunotherapy including systemic central nervous system (CNS)
prophylaxis improves outcome and reduces the incidence of CNS-related events. Patients
and methods Inclusion criteria were age 18–65 years, primary diffuse large B-cell lymphoma
or grade III follicular lymphoma without clinical signs of CNS disease and negative …
Background
Many patients with aggressive B-cell lymphomas and high clinical risk score still die of lymphoma after conventional R-CHOP chemoimmunotherapy. We hypothesized that intensified chemoimmunotherapy including systemic central nervous system (CNS) prophylaxis improves outcome and reduces the incidence of CNS-related events.
Patients and methods
Inclusion criteria were age 18–65 years, primary diffuse large B-cell lymphoma or grade III follicular lymphoma without clinical signs of CNS disease and negative cerebrospinal fluid cytology, age-adjusted International Prognostic Index 2–3 and WHO performance score 0–3. Treatment consisted of six courses of R-CHOEP-14 followed by a course of high-dose cytarabine and a course of high-dose methotrexate. Primary end point was failure-free survival (FFS) at 3 years.
Results
A total of 156 eligible patients with a median age of 54 years (range 20–64) were included. Three toxic deaths were observed. Three-year overall survival (OS) and FFS rates (median observation time 52 months for survivors) were 81% and 65%, respectively. Seven patients experienced CNS relapse, all within 6 months.
Conclusions
The results are promising with favorable 3-year OS and FFS rates, a low toxic death rate and a lower than expected number of CNS events. CNS progression might be further reduced by earlier CNS prophylaxis.
CinicalTrials.gov. identifier
NCT01502982.
Elsevier
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