R-CHOP without radiation in frontline management of primary mediastinal B-cell lymphoma

Research output: Contribution to journalArticle

Abstract

Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.

Original languageEnglish (US)
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

B-Cell Lymphoma
Radiation
Radiation Effects
Vincristine
Prednisone
Treatment Failure
Doxorubicin
Cyclophosphamide
Disease-Free Survival
Drug Therapy
Survival
Rituximab

Keywords

  • diffuse large B-cell lymphoma
  • DLBCL
  • non-Hodgkin lymphoma
  • PMBCL
  • Primary mediastinal B-cell lymphoma
  • R-CHOP

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "R-CHOP without radiation in frontline management of primary mediastinal B-cell lymphoma",
abstract = "Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56{\%} with bulky disease, 75{\%} with elevated LDH, 25{\%} with SVC syndrome, and 13{\%} with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93{\%} and 100{\%} respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.",
keywords = "diffuse large B-cell lymphoma, DLBCL, non-Hodgkin lymphoma, PMBCL, Primary mediastinal B-cell lymphoma, R-CHOP",
author = "Marcus Messmer and Tsai, {Hua Ling} and Ravi Varadhan and Lode Swinnen and Jones, {Richard J} and Ambinder, {Richard F} and Shanbhag, {Satish P} and Borowitz, {Michael J} and Nina Wagner-Johnston",
year = "2019",
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doi = "10.1080/10428194.2018.1519812",
language = "English (US)",
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T1 - R-CHOP without radiation in frontline management of primary mediastinal B-cell lymphoma

AU - Messmer, Marcus

AU - Tsai, Hua Ling

AU - Varadhan, Ravi

AU - Swinnen, Lode

AU - Jones, Richard J

AU - Ambinder, Richard F

AU - Shanbhag, Satish P

AU - Borowitz, Michael J

AU - Wagner-Johnston, Nina

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.

AB - Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.

KW - diffuse large B-cell lymphoma

KW - DLBCL

KW - non-Hodgkin lymphoma

KW - PMBCL

KW - Primary mediastinal B-cell lymphoma

KW - R-CHOP

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