Outcome of primary mediastinal large B-cell lymphoma using R-CHOP: impact of a PET-adapted approach
Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role of radiotherapy (RT) remains ill-defined. Herein, we evaluated the outcome of PMBCL primarily treated with rituximab, cyclophosphamide, doxo...
Uloženo v:
| Vydáno v: | Blood Ročník 136; číslo 24; s. 2803 |
|---|---|
| Hlavní autoři: | , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
10.12.2020
|
| Témata: | |
| ISSN: | 1528-0020, 1528-0020 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role of radiotherapy (RT) remains ill-defined. Herein, we evaluated the outcome of PMBCL primarily treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and the impact of an end-of-treatment (EOT) 18F-fluorodeoxyglucose positron emission tomography (PET) scan to guide consolidative RT. Patients ≥18 years of age with PMBCL treated with curative intent rituximab-chemotherapy were identified. Prior to 2005, patients were recommended to receive R-CHOP + RT (RT era). Beginning in 2005, EOT PET was used to guide RT and only those with a PET-positive scan received RT (PET era). In total, 159 patients were identified, 94% were treated with R-CHOP and 44% received RT (78% in RT era, 28% in PET era). The 5-year time to progression (TTP) and overall survival (OS) for the entire cohort were 80% and 89%, respectively, similar across treatment eras. Overall, 10% had refractory disease. In total, 113 patients had an EOT PET scan: 63% negative and 37% positive with a 5-year TTP of 90% vs 71% and 5-year OS of 97% vs 88%, respectively. For those with Deauville (D)-scored PET scans (n = 103), the 5-year TTP for PET-negative cases by Deauville criteria (D1-D3, DX) was 91%, with inferior outcomes for D5 vs D4 (5-year TTP 33% vs 87%, P = .0002). Outcomes for PMBCL treated with RCHOP are favorable and use of a PET-adapted approach reduces RT in the majority of patients. A small proportion have refractory disease and may benefit from an alternate treatment. |
|---|---|
| AbstractList | Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role of radiotherapy (RT) remains ill-defined. Herein, we evaluated the outcome of PMBCL primarily treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and the impact of an end-of-treatment (EOT) 18F-fluorodeoxyglucose positron emission tomography (PET) scan to guide consolidative RT. Patients ≥18 years of age with PMBCL treated with curative intent rituximab-chemotherapy were identified. Prior to 2005, patients were recommended to receive R-CHOP + RT (RT era). Beginning in 2005, EOT PET was used to guide RT and only those with a PET-positive scan received RT (PET era). In total, 159 patients were identified, 94% were treated with R-CHOP and 44% received RT (78% in RT era, 28% in PET era). The 5-year time to progression (TTP) and overall survival (OS) for the entire cohort were 80% and 89%, respectively, similar across treatment eras. Overall, 10% had refractory disease. In total, 113 patients had an EOT PET scan: 63% negative and 37% positive with a 5-year TTP of 90% vs 71% and 5-year OS of 97% vs 88%, respectively. For those with Deauville (D)-scored PET scans (n = 103), the 5-year TTP for PET-negative cases by Deauville criteria (D1-D3, DX) was 91%, with inferior outcomes for D5 vs D4 (5-year TTP 33% vs 87%, P = .0002). Outcomes for PMBCL treated with RCHOP are favorable and use of a PET-adapted approach reduces RT in the majority of patients. A small proportion have refractory disease and may benefit from an alternate treatment. Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role of radiotherapy (RT) remains ill-defined. Herein, we evaluated the outcome of PMBCL primarily treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and the impact of an end-of-treatment (EOT) 18F-fluorodeoxyglucose positron emission tomography (PET) scan to guide consolidative RT. Patients ≥18 years of age with PMBCL treated with curative intent rituximab-chemotherapy were identified. Prior to 2005, patients were recommended to receive R-CHOP + RT (RT era). Beginning in 2005, EOT PET was used to guide RT and only those with a PET-positive scan received RT (PET era). In total, 159 patients were identified, 94% were treated with R-CHOP and 44% received RT (78% in RT era, 28% in PET era). The 5-year time to progression (TTP) and overall survival (OS) for the entire cohort were 80% and 89%, respectively, similar across treatment eras. Overall, 10% had refractory disease. In total, 113 patients had an EOT PET scan: 63% negative and 37% positive with a 5-year TTP of 90% vs 71% and 5-year OS of 97% vs 88%, respectively. For those with Deauville (D)-scored PET scans (n = 103), the 5-year TTP for PET-negative cases by Deauville criteria (D1-D3, DX) was 91%, with inferior outcomes for D5 vs D4 (5-year TTP 33% vs 87%, P = .0002). Outcomes for PMBCL treated with RCHOP are favorable and use of a PET-adapted approach reduces RT in the majority of patients. A small proportion have refractory disease and may benefit from an alternate treatment.Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role of radiotherapy (RT) remains ill-defined. Herein, we evaluated the outcome of PMBCL primarily treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and the impact of an end-of-treatment (EOT) 18F-fluorodeoxyglucose positron emission tomography (PET) scan to guide consolidative RT. Patients ≥18 years of age with PMBCL treated with curative intent rituximab-chemotherapy were identified. Prior to 2005, patients were recommended to receive R-CHOP + RT (RT era). Beginning in 2005, EOT PET was used to guide RT and only those with a PET-positive scan received RT (PET era). In total, 159 patients were identified, 94% were treated with R-CHOP and 44% received RT (78% in RT era, 28% in PET era). The 5-year time to progression (TTP) and overall survival (OS) for the entire cohort were 80% and 89%, respectively, similar across treatment eras. Overall, 10% had refractory disease. In total, 113 patients had an EOT PET scan: 63% negative and 37% positive with a 5-year TTP of 90% vs 71% and 5-year OS of 97% vs 88%, respectively. For those with Deauville (D)-scored PET scans (n = 103), the 5-year TTP for PET-negative cases by Deauville criteria (D1-D3, DX) was 91%, with inferior outcomes for D5 vs D4 (5-year TTP 33% vs 87%, P = .0002). Outcomes for PMBCL treated with RCHOP are favorable and use of a PET-adapted approach reduces RT in the majority of patients. A small proportion have refractory disease and may benefit from an alternate treatment. |
| Author | Slack, Graham W Villa, Diego Farinha, Pedro Sehn, Laurie H Gerrie, Alina S Savage, Kerry J Hayden, Anna R Scott, David W Lee, Derrick G Freeman, Ciara L Benard, Francois Lo, Andrea Yenson, Paul R Skinnider, Brian Tonseth, Petter Pickles, Tom Wilson, Donald Connors, Joseph M |
| Author_xml | – sequence: 1 givenname: Anna R surname: Hayden fullname: Hayden, Anna R organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 2 givenname: Petter surname: Tonseth fullname: Tonseth, Petter organization: Division of Radiology, BC Cancer, Vancouver, BC, Canada – sequence: 3 givenname: Derrick G surname: Lee fullname: Lee, Derrick G organization: Cancer Control Research and – sequence: 4 givenname: Diego surname: Villa fullname: Villa, Diego organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 5 givenname: Alina S surname: Gerrie fullname: Gerrie, Alina S organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 6 givenname: David W surname: Scott fullname: Scott, David W organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 7 givenname: Ciara L surname: Freeman fullname: Freeman, Ciara L organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 8 givenname: Graham W surname: Slack fullname: Slack, Graham W organization: Centre for Lymphoid Cancer and Division of Pathology, BC Cancer, Vancouver, BC, Canada – sequence: 9 givenname: Pedro surname: Farinha fullname: Farinha, Pedro organization: Centre for Lymphoid Cancer and Division of Pathology, BC Cancer, Vancouver, BC, Canada – sequence: 10 givenname: Brian surname: Skinnider fullname: Skinnider, Brian organization: Centre for Lymphoid Cancer and Division of Pathology, BC Cancer, Vancouver, BC, Canada – sequence: 11 givenname: Paul R surname: Yenson fullname: Yenson, Paul R organization: Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; and – sequence: 12 givenname: Francois surname: Benard fullname: Benard, Francois organization: Division of Radiology, BC Cancer, Vancouver, BC, Canada – sequence: 13 givenname: Andrea surname: Lo fullname: Lo, Andrea organization: Department of Radiation Oncology, BC Cancer, Vancouver, BC, Canada – sequence: 14 givenname: Tom surname: Pickles fullname: Pickles, Tom organization: Department of Radiation Oncology, BC Cancer, Vancouver, BC, Canada – sequence: 15 givenname: Donald surname: Wilson fullname: Wilson, Donald organization: Division of Radiology, BC Cancer, Vancouver, BC, Canada – sequence: 16 givenname: Joseph M surname: Connors fullname: Connors, Joseph M organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 17 givenname: Laurie H surname: Sehn fullname: Sehn, Laurie H organization: Centre for Lymphoid Cancer and Department of Medical Oncology and – sequence: 18 givenname: Kerry J surname: Savage fullname: Savage, Kerry J organization: Centre for Lymphoid Cancer and Department of Medical Oncology and |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32603413$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkElPwzAQhS1URBe4c0I-cnHxlo0bVIUiVWqFyjkaO04bFMchTg7993VFkTjNjObpzXxvikaNawxC94zOGUv5k6qdK-acsoxSybP4Ck1YxFNCKaejf_0YTb3_ppRJwaMbNBY8pkIyMUF6M_TaWYNdiduustAdsTVFBb6vGqhxDd3e4FeiTR2Go20PzgIefNXs8SdZrDbbZ1zZFnR_dgC8Xe4IFND2psDQtp0DfbhF1yXU3txd6gx9vS13ixVZb94_Fi9romWU9qQsFFU6FjHPojjTQmkjOIAI20zLRJdxEtHgHXBLUSglWFLwJFVADeUxGD5Dj7--4ezPYHyf28qfH4fGuMHnXLJMhghEEqQPF-mgAm5-Qc__guEn3pFnMQ |
| CitedBy_id | crossref_primary_10_1111_1759_7714_14155 crossref_primary_10_3390_diagnostics13122027 crossref_primary_10_1093_milmed_usac238 crossref_primary_10_2298_VSP241015013M crossref_primary_10_1016_j_ejca_2025_115369 crossref_primary_10_1038_s41571_023_00799_2 crossref_primary_10_1200_JCO_24_01373 crossref_primary_10_3390_hematolrep17030023 crossref_primary_10_1016_j_clml_2023_08_014 crossref_primary_10_1080_14737140_2021_1953986 crossref_primary_10_1259_bjr_20210576 crossref_primary_10_1182_bloodadvances_2021004778 crossref_primary_10_1002_cam4_4387 crossref_primary_10_1055_a_1506_7829 crossref_primary_10_1111_ejh_13727 crossref_primary_10_1097_HS9_0000000000000965 crossref_primary_10_1016_j_clml_2025_02_013 crossref_primary_10_1053_j_seminhematol_2023_12_003 crossref_primary_10_3390_medicina58010048 crossref_primary_10_1186_s12885_022_09988_1 crossref_primary_10_1038_s41408_021_00491_7 crossref_primary_10_3390_cancers16061090 crossref_primary_10_1007_s11307_022_01703_7 crossref_primary_10_1016_j_semradonc_2024_07_011 crossref_primary_10_1016_j_clml_2021_06_012 crossref_primary_10_1002_onco_13789 crossref_primary_10_1016_j_ctrv_2025_102898 crossref_primary_10_1186_s40164_023_00396_0 crossref_primary_10_1016_j_clml_2024_07_019 crossref_primary_10_1007_s00277_021_04421_2 crossref_primary_10_1016_j_humpath_2024_105705 crossref_primary_10_1182_blood_2020007766 crossref_primary_10_1200_GO_21_00320 crossref_primary_10_1182_bloodadvances_2024015577 crossref_primary_10_3390_cancers16244265 crossref_primary_10_3389_fonc_2021_654854 crossref_primary_10_1016_j_clml_2023_08_021 crossref_primary_10_1111_ejh_13715 crossref_primary_10_1182_blood_2020008376 crossref_primary_10_1053_j_semnuclmed_2022_11_001 crossref_primary_10_1038_s41598_022_14067_3 crossref_primary_10_1002_hon_3096 crossref_primary_10_1007_s00262_023_03467_7 crossref_primary_10_2147_JBM_S393180 crossref_primary_10_1097_HS9_0000000000000917 crossref_primary_10_1177_20406207211048959 |
| ContentType | Journal Article |
| Copyright | 2020 by The American Society of Hematology. |
| Copyright_xml | – notice: 2020 by The American Society of Hematology. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1182/blood.2019004296 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine Chemistry Biology Anatomy & Physiology |
| EISSN | 1528-0020 |
| ExternalDocumentID | 32603413 |
| Genre | Clinical Trial Journal Article |
| GroupedDBID | --- -~X .55 0R~ 23N 2WC 34G 39C 4.4 53G 5GY 5RE 5VS 6J9 AAEDW AALRI AAXUO ABOCM ACGFO ADBBV ADVLN AENEX AFETI AFOSN AITUG AKRWK ALMA_UNASSIGNED_HOLDINGS AMRAJ BAWUL BTFSW CGR CS3 CUY CVF DIK DU5 E3Z EBS ECM EIF EJD EX3 F5P FDB FRP GS5 GX1 H13 IH2 K-O KQ8 L7B LSO MJL N9A NPM OK1 P2P R.V RHF RHI ROL SJN THE TR2 TWZ W2D W8F WH7 WOQ WOW X7M YHG YKV 7X8 ACVFH ADCNI AEUPX AFPUW AIGII AKBMS AKYEP EFKBS |
| ID | FETCH-LOGICAL-c458t-fdb0bc63629569c3bce32aa3c459c47cf6750ada201f3dbb317d278ba0e026ae2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 62 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000599693500013&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1528-0020 |
| IngestDate | Sun Nov 23 09:51:54 EST 2025 Wed Feb 19 02:28:12 EST 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 24 |
| Language | English |
| License | 2020 by The American Society of Hematology. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c458t-fdb0bc63629569c3bce32aa3c459c47cf6750ada201f3dbb317d278ba0e026ae2 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| OpenAccessLink | https://ashpublications.org/blood/article-pdf/136/24/2803/1793642/bloodbld2019004296.pdf |
| PMID | 32603413 |
| PQID | 2419414337 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2419414337 pubmed_primary_32603413 |
| PublicationCentury | 2000 |
| PublicationDate | 2020-12-10 20201210 |
| PublicationDateYYYYMMDD | 2020-12-10 |
| PublicationDate_xml | – month: 12 year: 2020 text: 2020-12-10 day: 10 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Blood |
| PublicationTitleAlternate | Blood |
| PublicationYear | 2020 |
| References | 33301033 - Blood. 2020 Dec 10;136(24):2725-2726 |
| References_xml | – reference: 33301033 - Blood. 2020 Dec 10;136(24):2725-2726 |
| SSID | ssj0014325 |
| Score | 2.5630195 |
| Snippet | Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 2803 |
| SubjectTerms | Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - administration & dosage Cyclophosphamide - administration & dosage Disease-Free Survival Doxorubicin - administration & dosage Female Follow-Up Studies Humans Lymphoma, Large B-Cell, Diffuse - diagnostic imaging Lymphoma, Large B-Cell, Diffuse - drug therapy Lymphoma, Large B-Cell, Diffuse - mortality Male Mediastinal Neoplasms - diagnostic imaging Mediastinal Neoplasms - drug therapy Mediastinal Neoplasms - mortality Middle Aged Positron-Emission Tomography Prednisone - administration & dosage Rituximab - administration & dosage Survival Rate Vincristine - administration & dosage |
| Title | Outcome of primary mediastinal large B-cell lymphoma using R-CHOP: impact of a PET-adapted approach |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/32603413 https://www.proquest.com/docview/2419414337 |
| Volume | 136 |
| WOSCitedRecordID | wos000599693500013&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1bS8MwFD6o8_biZd7mjQjiWzBL0psvomPiy7YiCnsbadKKsLXTbYL_3pO0xSdB8CUUSpP2JD3fdy7JAbiUKopkIhUVyFepTAyjIc4u5W0VCYMt08wVmwj6_XA4jOLK4Tar0iprnegUtSm09ZFfI9JEEsFdBLfTd2qrRtnoalVCYxkaAqmMTekKhj9RBClc0VWEqJBaXlSHKUN-7dLCbWZX5FSy_zvBdEDzsP3fV9yBrYpikrtyTezCUpo3Ye8uR_N68kWuiEv6dN70Jqzd11cbnbr0WxPWe1XEfQ_0YDHH0VNSZGRankxB3G4TVA12lLHNJCf31AYAyPgL10YxUcRm07-SJ9p5HMQ3pNyJaXtQJO4-U2XUFIkuqc8z34eXh-5z55FWhRmoll44p5lJWKJ9xD60riItEp0KrpTAu5GWgc7QCmHYF4o3EyZJkKMYHoSJYimafCrlB7CSF3l6BMTXTBo_EJ7xjDvcPsvawjDPKMVDP-AtuKhlPUIh2I9ReVosZqMfabfgsJywUSWHEXJSZuH5-A9Pn8AmtzZ0myMknUIjw98-PYNV_Tl_m32cuxWFbT_ufQPIzdPY |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Outcome+of+primary+mediastinal+large+B-cell+lymphoma+using+R-CHOP%3A+impact+of+a+PET-adapted+approach&rft.jtitle=Blood&rft.au=Hayden%2C+Anna+R&rft.au=Tonseth%2C+Petter&rft.au=Lee%2C+Derrick+G&rft.au=Villa%2C+Diego&rft.date=2020-12-10&rft.issn=1528-0020&rft.eissn=1528-0020&rft.volume=136&rft.issue=24&rft.spage=2803&rft_id=info:doi/10.1182%2Fblood.2019004296&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1528-0020&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1528-0020&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1528-0020&client=summon |