Salvage chemotherapy and autologous stem cell transplantation are inferior for relapsed or refractory primary mediastinal large B-cell lymphoma compared with diffuse large B-cell lymphoma

被引:87
作者
Kuruvilla, John [1 ,2 ]
Pintilie, Melania [3 ]
Tsang, Richard [4 ]
Nagy, Tracy [2 ]
Keating, Armand [1 ,2 ]
Crump, Michael [1 ,2 ]
机构
[1] Princess Margaret Hosp, Div Med Oncol & Hematol, Toronto, ON M5G 2M9, Canada
[2] Princess Margaret Hosp, Autologous Blood & Marrow Transplant Programme, Toronto, ON M5G 2M9, Canada
[3] Princess Margaret Hosp, Clin Study Coordinat & Biostat, Toronto, ON M5G 2M9, Canada
[4] Princess Margaret Hosp, Dept Radiat Oncol, Toronto, ON M5G 2M9, Canada
关键词
salvage chemotherapy; primary mediastinal large B-cell lymphoma; stem cell transplant;
D O I
10.1080/10428190802108870
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Primary mediastinal large B-cell lymphoma (PMLCL) is an aggressive non-Hodgkin lymphoma with distinct clinical and gene expression profiles. Outcomes of salvage chemotherapy and autologous stem cell transplantation (ASCT) for relapsed or refractory disease (RR) have not been well characterised. We retrospectively identified 180 consecutive RR patients (37 PMLCL and a control group of 143 DLBCL) that underwent salvage chemotherapy. The overall response rate (ORR) to salvage chemotherapy (25% vs. 48%, p=0.01) and 2-year OS after diagnosis of RR disease (15% vs. 34%, p=0.018) was inferior in PMLCL patients. The 2-year post-ASCT OS (67% PMLCL vs. 53%, p=0.78) and PFS (57% PMLCL vs. 36%, p=0.64) were similar. RR PMLCL had an inferior ORR and survival compared with DLBCL but chemosensitive PMLCL and DLBCL patients have similar outcomes post-ASCT. Strategies for PMLCL should focus on identifying poor risk patients to test novel induction and salvage strategies.
引用
收藏
页码:1329 / 1336
页数:8
相关论文
共 42 条
[1]   Efficacy of an early intensification treatment integrating chemotherapy, autologous stem cell transplantation and radiotherapy for poor risk primary mediastinal large B cell lymphoma with sclerosis [J].
Cairoli, R ;
Grillo, G ;
Tedeschi, A ;
Gargantini, L ;
Marenco, P ;
Tresoldi, E ;
Barbarano, L ;
Nosari, AM ;
Morra, E .
BONE MARROW TRANSPLANTATION, 2002, 29 (06) :473-477
[2]   Primary mediastinal large B-cell lymphoma - A clinicopathologic study of 141 cases compared with 916 nonmediastinal large B-cell lymphomas, a GELA (''Groupe d'Etude des Lymphomes de L'adulte'') study [J].
CazalsHatem, D ;
Lepage, E ;
Brice, P ;
Ferrant, A ;
dAgay, MF ;
Baumelou, E ;
Briere, J ;
Blanc, M ;
Gaulard, P ;
Biron, P ;
Schlaifer, D ;
Diebold, J ;
Audouin, J .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1996, 20 (07) :877-888
[3]   Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas [J].
Cheson, BD ;
Horning, SJ ;
Coiffier, B ;
Shipp, MA ;
Fisher, RI ;
Connors, JM ;
Lister, TA ;
Vose, J ;
Grillo-López, A ;
Hagenbeek, A ;
Cabanillas, F ;
Klippensten, D ;
Hiddemann, W ;
Castellino, R ;
Harris, NL ;
Armitage, JO ;
Carter, W ;
Hoppe, R ;
Canellos, GP .
JOURNAL OF CLINICAL ONCOLOGY, 1999, 17 (04) :1244-1253
[4]   Gemcitabine, dexamethasone, and cisplatin in patients with recurrent or refractory aggressive histology B-cell non-Hodgkin lymphoma - A phase II study by the National Cancer Institute of Canada Clinical Trials Group (NCIC-CTG) [J].
Crump, M ;
Baetz, T ;
Couban, S ;
Belch, A ;
Marcellus, D ;
Howson-Jan, K ;
Imrie, K ;
Myers, R ;
Adams, G ;
Ding, KY ;
Paul, N ;
Shepherd, L ;
Iglesias, J ;
Meyer, R .
CANCER, 2004, 101 (08) :1835-1842
[5]   NFκB activity, function, and target-gene signatures in primary mediastinal large B-cell lymphoma and diffuse large B-cell lymphoma subtypes [J].
Feuerhake, F ;
Kutok, JL ;
Monti, S ;
Chen, W ;
LaCasce, AS ;
Cattoretti, G ;
Kurtin, P ;
Pinkus, GS ;
de Leval, L ;
Harris, NL ;
Savage, KJ ;
Neuberg, D ;
Habermann, TM ;
Dalla-Favera, R ;
Golub, TR ;
Aster, JC ;
Shipp, MA .
BLOOD, 2005, 106 (04) :1392-1399
[6]   COMPARISON OF A STANDARD REGIMEN (CHOP) WITH 3 INTENSIVE CHEMOTHERAPY REGIMENS FOR ADVANCED NON-HODGKINS-LYMPHOMA [J].
FISHER, RI ;
GAYNOR, ER ;
DAHLBERG, S ;
OKEN, MM ;
GROGAN, TM ;
MIZE, EM ;
GLICK, JH ;
COLTMAN, CA ;
MILLER, TP .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (14) :1002-1006
[7]   Salvage chemotherapy with mini-BEAM for relapsed or refractory non-Hodgkin's lymphoma prior to autologous bone marrow transplantation [J].
Girouard, C ;
Dufresne, J ;
Imrie, K ;
Stewart, AK ;
Brandwein, J ;
Prince, HM ;
Pantolony, D ;
Keating, A ;
Crump, M .
ANNALS OF ONCOLOGY, 1997, 8 (07) :675-680
[8]   Efficacy of high-dose therapy and autologous hematopoietic stem cell transplantation for non-Hodgkin's lymphoma in adults 60 years of age and older [J].
Gopal, AK ;
Gooley, TA ;
Golden, JB ;
Maloney, DG ;
Bensinger, WI ;
Petersdorf, SH ;
Appelbaum, FR ;
Press, OW .
BONE MARROW TRANSPLANTATION, 2001, 27 (06) :593-599
[9]   Constitutive STAT6 activation in primary mediastinal large B-cell lymphoma [J].
Guiter, C ;
Dusanter-Fourt, I ;
Copie-Bergman, C ;
Boulland, ML ;
le Gouvello, S ;
Gaulard, P ;
Leroy, K ;
Castellano, F .
BLOOD, 2004, 104 (02) :543-549
[10]  
HAAS R, 1994, BLOOD, V83, P3787