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Torka P , Kothari SK , Sundaram S , Li SY , Medeiros LJ , Ayers EC , Landsburg DJ , Bond DA , Maddocks KJ , Giri A , Hess B , Pham LQ , Advani R , Liu Y , Barta SK , Vose JM , Churnetski MC , Cohen JB , Burkart M , Karmali R , Zurko J , Mehta A , Olszewski AJ , Lee S , Hill BT , Burns TF , Lansigan F , Rabinovich E , Peace D , Groman A , Attwood K , Hernandez-Ilizaliturri FJ
Outcomes of patients with limited-stage aggressive large B-cell lymphoma with high-risk cytogenetics
Blood Advances. 2020 Jan;4(2) :253-262
PMID: 31945157    PMCID: PMC6988401    URL: https://www.ncbi.nlm.nih.gov/pubmed/31945157
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Abstract
There is a paucity of data regarding outcomes and response to standard therapy in patients with limited-stage (LS) agressive B-cell lymphoma (LS-ABCL) who harbor MYC rearrangement (MYC-R) with or without BCL2 and/or BCL6 rearrangements. We conducted a multicenter retrospective study of MYC-R LS-ABCL patients who received either rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), or more intensive immunochemotherapy (IIC) plus or minus consolidative involved-field radiation therapy (IFRT). One hundred four patients from 15 academic centers were included. Forty four patients (42%) received R-CHOP, of whom 52% had IFRT. Sixty patients (58%) received IIC, of whom 40% had IFRT. Overall response rate was 91% (84% complete response [CR]; 7% partial response). Patients with double-hit lymphoma (DHL; n = 40) had a lower CR rate compared with patients with MYC-R only (75% vs 98%; P = .003). CR rate was higher in the IFRT vs no-IFRT group (98% vs 72%; P < .001). Median follow-up was 3.2 years; 2-year progression-free survival (PFS) and overal survival (OS) were 78% and 86% for the entire cohort, and 74% and 81% for the DHL patients, respectively. PFS and OS were similar across treatment groups (IFRT vs no IFRT, R-CHOP vs IIC) in the entire cohort and in DHL patients. Our data provide a historical benchmark for MYC-R LS-ABCL and LS-DHL patients and show that outcomes for this population may be better than previously recognized. There was no benefit of using IIC over R-CHOP in patients with MYC-R LS-ABCL and LS-DHL.
Notes
Torka, Pallawi Kothari, Shalin K. Sundaram, Suchitra Li, Shaoying Medeiros, L. Jeffrey Ayers, Emily C. Landsburg, Daniel J. Bond, David A. Maddocks, Kami J. Giri, Anshu Hess, Brian Pham, Luu Q. Advani, Ranjana Liu, Yang Barta, Stefan Klaus Vose, Julie M. Churnetski, Michael C. Cohen, Jonathon B. Burkart, Madelyn Karmali, Reem Zurko, Joanna Mehta, Amitkumar Olszewski, Adam J. Lee, Sarah Hill, Brian T. Burns, Timothy F. Lansigan, Frederick Rabinovich, Emma Peace, David Groman, Adrienne Attwood, Kristopher Hernandez-Ilizaliturri, Francisco J. Li, Shaoying/0000-0002-6857-0523 2473-9537 P30 CA016056/CA/NCI NIH HHS/ T32 CA009679/CA/NCI NIH HHS/ UL1 TR001863/TR/NCATS NIH HHS/ Blood Adv. 2020 Jan 28;4(2):253-262. doi: 10.1182/bloodadvances.2019000875