GOOD RESULTS WITH R-CHOP-14 THERAPY IN PRIMARY MEDIASTINAL LARGE B-CELL LYMPHOMAS. THE CHEMOKINE TARC IS AN EXCELLENT MARKER OF TUMOR ACTIVITY AND IN TREATMENT EFFECTIVITY IN MEDIASTINAL LYMPHOMAS.
(Abstract release date: 05/19/16)
EHA Library. Schneider T. 06/09/16; 134583; PB1683
Dr. Tamas Schneider
Contributions
Contributions
Abstract
Abstract: PB1683
Type: Publication Only
Background
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare disease that belongs to the group of aggressive, diffuse large B-cell lymphomas and is associated with a characteristic clinical feature. Data from evidence-based treatments are not available. Retrospective studies suggest that the so called third generation treatments are more effective than the previous standard treatment with 21-day cycles R-CHOP. Nowadays, dose-dense DA-EPOCH-R treatment is well tolerated by young patients and appears to be even more effective.
Aims
Our research shows that dose-dense R-CHOP-14 treatment is as effective as the more aggressive DA-EPOCH-R. There is no earlier data for the role of TARC (thymus activation-regulated chemokine) in PMBCL as a disease activity marker. The change of TARC level during the treatment was monitored.
Methods
Between July 2005 and June 2015, 56 newly diagnosed, untreated PMBCL patients were subject to treatment with R-CHOP-14. The average age of the 33 (59 %) female and 23 (41 %) male patients was 32 years (range: 21-53 years). Using the R-IPI, 9 patients were the very good, 46 patients were the good and one patient was in the worse prognostic group. The combination of CHOP-14 and rituximab administered in 14-day cycles was used as treatment; the treatment regimen also included preventive administration of filgastrim. The average number of cycles of the chemotherapeutic treatments was 6.6 (range: 4-8). After the final R-CHOP-14 treatment high energy photon radiation was used to the residual mediastinal abnormalities in 46 cases as consolidation treatment. Before diagnosis could be performed two patients received life-saving irradiation. Since May 2013 we have investigated the role of TARC to follow the disease activity in 13 cases.
Results
The planed treatment was completed in 55 (98.2 %) patients and in 54 (96.4 %) patients we achieved complete remission verified by PET/CT. One patient, who did not get complete remission, was cured with high-dose chemotherapy and autologous stem cell transplantation. One patient died after the fourth cycle R-CHOP-14, due restrictive pulmonary disease and ARDS. The average duration of the follow-up period was 57 months (range: 10-126 months), during which time only one relapse was shown. The relapse free survival is 98.1 %. One patient did not wish to receive further oncological treatment, she was only one who died due lymphoma. The lymphoma specific mortality is 98.2 %. Two young female patients (with hereditary mental retardation) died in lung tuberculosis 9 and 13 month after the end of the treatment. The overall survival rate is 92.9 %; the event free survival is 91.1 %. Before the treatment all but one out of 13 cases extremely high TARC level was found. The TARC levels were dropped quickly in the normal range due the treatment effect.
Conclusion
In the treatment of PMBCL the R-CHOP-14 was found highly effective, short-term and well tolerable. Further investigation and research is needed to find out if radiation therapy is necessary. The TARC proved to be a very good marker in PMBCL which signs the activity of disease and the effectivity of treatment well and early.
Session topic: E-poster
Keyword(s): Chemokine, Diffuse large B cell lymphoma, Dose intensity, Immunotherapy
Type: Publication Only
Background
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare disease that belongs to the group of aggressive, diffuse large B-cell lymphomas and is associated with a characteristic clinical feature. Data from evidence-based treatments are not available. Retrospective studies suggest that the so called third generation treatments are more effective than the previous standard treatment with 21-day cycles R-CHOP. Nowadays, dose-dense DA-EPOCH-R treatment is well tolerated by young patients and appears to be even more effective.
Aims
Our research shows that dose-dense R-CHOP-14 treatment is as effective as the more aggressive DA-EPOCH-R. There is no earlier data for the role of TARC (thymus activation-regulated chemokine) in PMBCL as a disease activity marker. The change of TARC level during the treatment was monitored.
Methods
Between July 2005 and June 2015, 56 newly diagnosed, untreated PMBCL patients were subject to treatment with R-CHOP-14. The average age of the 33 (59 %) female and 23 (41 %) male patients was 32 years (range: 21-53 years). Using the R-IPI, 9 patients were the very good, 46 patients were the good and one patient was in the worse prognostic group. The combination of CHOP-14 and rituximab administered in 14-day cycles was used as treatment; the treatment regimen also included preventive administration of filgastrim. The average number of cycles of the chemotherapeutic treatments was 6.6 (range: 4-8). After the final R-CHOP-14 treatment high energy photon radiation was used to the residual mediastinal abnormalities in 46 cases as consolidation treatment. Before diagnosis could be performed two patients received life-saving irradiation. Since May 2013 we have investigated the role of TARC to follow the disease activity in 13 cases.
Results
The planed treatment was completed in 55 (98.2 %) patients and in 54 (96.4 %) patients we achieved complete remission verified by PET/CT. One patient, who did not get complete remission, was cured with high-dose chemotherapy and autologous stem cell transplantation. One patient died after the fourth cycle R-CHOP-14, due restrictive pulmonary disease and ARDS. The average duration of the follow-up period was 57 months (range: 10-126 months), during which time only one relapse was shown. The relapse free survival is 98.1 %. One patient did not wish to receive further oncological treatment, she was only one who died due lymphoma. The lymphoma specific mortality is 98.2 %. Two young female patients (with hereditary mental retardation) died in lung tuberculosis 9 and 13 month after the end of the treatment. The overall survival rate is 92.9 %; the event free survival is 91.1 %. Before the treatment all but one out of 13 cases extremely high TARC level was found. The TARC levels were dropped quickly in the normal range due the treatment effect.
Conclusion
In the treatment of PMBCL the R-CHOP-14 was found highly effective, short-term and well tolerable. Further investigation and research is needed to find out if radiation therapy is necessary. The TARC proved to be a very good marker in PMBCL which signs the activity of disease and the effectivity of treatment well and early.
Session topic: E-poster
Keyword(s): Chemokine, Diffuse large B cell lymphoma, Dose intensity, Immunotherapy
Abstract: PB1683
Type: Publication Only
Background
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare disease that belongs to the group of aggressive, diffuse large B-cell lymphomas and is associated with a characteristic clinical feature. Data from evidence-based treatments are not available. Retrospective studies suggest that the so called third generation treatments are more effective than the previous standard treatment with 21-day cycles R-CHOP. Nowadays, dose-dense DA-EPOCH-R treatment is well tolerated by young patients and appears to be even more effective.
Aims
Our research shows that dose-dense R-CHOP-14 treatment is as effective as the more aggressive DA-EPOCH-R. There is no earlier data for the role of TARC (thymus activation-regulated chemokine) in PMBCL as a disease activity marker. The change of TARC level during the treatment was monitored.
Methods
Between July 2005 and June 2015, 56 newly diagnosed, untreated PMBCL patients were subject to treatment with R-CHOP-14. The average age of the 33 (59 %) female and 23 (41 %) male patients was 32 years (range: 21-53 years). Using the R-IPI, 9 patients were the very good, 46 patients were the good and one patient was in the worse prognostic group. The combination of CHOP-14 and rituximab administered in 14-day cycles was used as treatment; the treatment regimen also included preventive administration of filgastrim. The average number of cycles of the chemotherapeutic treatments was 6.6 (range: 4-8). After the final R-CHOP-14 treatment high energy photon radiation was used to the residual mediastinal abnormalities in 46 cases as consolidation treatment. Before diagnosis could be performed two patients received life-saving irradiation. Since May 2013 we have investigated the role of TARC to follow the disease activity in 13 cases.
Results
The planed treatment was completed in 55 (98.2 %) patients and in 54 (96.4 %) patients we achieved complete remission verified by PET/CT. One patient, who did not get complete remission, was cured with high-dose chemotherapy and autologous stem cell transplantation. One patient died after the fourth cycle R-CHOP-14, due restrictive pulmonary disease and ARDS. The average duration of the follow-up period was 57 months (range: 10-126 months), during which time only one relapse was shown. The relapse free survival is 98.1 %. One patient did not wish to receive further oncological treatment, she was only one who died due lymphoma. The lymphoma specific mortality is 98.2 %. Two young female patients (with hereditary mental retardation) died in lung tuberculosis 9 and 13 month after the end of the treatment. The overall survival rate is 92.9 %; the event free survival is 91.1 %. Before the treatment all but one out of 13 cases extremely high TARC level was found. The TARC levels were dropped quickly in the normal range due the treatment effect.
Conclusion
In the treatment of PMBCL the R-CHOP-14 was found highly effective, short-term and well tolerable. Further investigation and research is needed to find out if radiation therapy is necessary. The TARC proved to be a very good marker in PMBCL which signs the activity of disease and the effectivity of treatment well and early.
Session topic: E-poster
Keyword(s): Chemokine, Diffuse large B cell lymphoma, Dose intensity, Immunotherapy
Type: Publication Only
Background
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare disease that belongs to the group of aggressive, diffuse large B-cell lymphomas and is associated with a characteristic clinical feature. Data from evidence-based treatments are not available. Retrospective studies suggest that the so called third generation treatments are more effective than the previous standard treatment with 21-day cycles R-CHOP. Nowadays, dose-dense DA-EPOCH-R treatment is well tolerated by young patients and appears to be even more effective.
Aims
Our research shows that dose-dense R-CHOP-14 treatment is as effective as the more aggressive DA-EPOCH-R. There is no earlier data for the role of TARC (thymus activation-regulated chemokine) in PMBCL as a disease activity marker. The change of TARC level during the treatment was monitored.
Methods
Between July 2005 and June 2015, 56 newly diagnosed, untreated PMBCL patients were subject to treatment with R-CHOP-14. The average age of the 33 (59 %) female and 23 (41 %) male patients was 32 years (range: 21-53 years). Using the R-IPI, 9 patients were the very good, 46 patients were the good and one patient was in the worse prognostic group. The combination of CHOP-14 and rituximab administered in 14-day cycles was used as treatment; the treatment regimen also included preventive administration of filgastrim. The average number of cycles of the chemotherapeutic treatments was 6.6 (range: 4-8). After the final R-CHOP-14 treatment high energy photon radiation was used to the residual mediastinal abnormalities in 46 cases as consolidation treatment. Before diagnosis could be performed two patients received life-saving irradiation. Since May 2013 we have investigated the role of TARC to follow the disease activity in 13 cases.
Results
The planed treatment was completed in 55 (98.2 %) patients and in 54 (96.4 %) patients we achieved complete remission verified by PET/CT. One patient, who did not get complete remission, was cured with high-dose chemotherapy and autologous stem cell transplantation. One patient died after the fourth cycle R-CHOP-14, due restrictive pulmonary disease and ARDS. The average duration of the follow-up period was 57 months (range: 10-126 months), during which time only one relapse was shown. The relapse free survival is 98.1 %. One patient did not wish to receive further oncological treatment, she was only one who died due lymphoma. The lymphoma specific mortality is 98.2 %. Two young female patients (with hereditary mental retardation) died in lung tuberculosis 9 and 13 month after the end of the treatment. The overall survival rate is 92.9 %; the event free survival is 91.1 %. Before the treatment all but one out of 13 cases extremely high TARC level was found. The TARC levels were dropped quickly in the normal range due the treatment effect.
Conclusion
In the treatment of PMBCL the R-CHOP-14 was found highly effective, short-term and well tolerable. Further investigation and research is needed to find out if radiation therapy is necessary. The TARC proved to be a very good marker in PMBCL which signs the activity of disease and the effectivity of treatment well and early.
Session topic: E-poster
Keyword(s): Chemokine, Diffuse large B cell lymphoma, Dose intensity, Immunotherapy
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