The treatment of primary mediastinal large B-cell lymphoma: a two decades monocentric experience with 98 patients

BMC Cancer

Research Article

Federica Quirini¹  Alessandro Broccoli¹  Vittorio Stefoni¹  Cinzia Pellegrini¹  Lisa Argnani¹  Lorenzo Tonialini¹  Miriam Marangon¹  Pier Luigi Zinzani¹  Beatrice Casadei¹  Alice Morigi¹ 

[1] Institute of Haematology “L. e A. Seràgnoli”, University of Bologna, Via Massarenti, 9 – 40138, Bologna, Italy;

关键词: Chemotherapy;    MACOP-B;    primary mediastinal lymphoma;    radiotherapy;    rituximab;   

DOI  :  10.1186/s12885-017-3269-6

 received in 2016-11-04, accepted in 2017-04-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma (PMLBCL) as they have been matter of debate for at least two decades.MethodsOur single centre experience in the treatment of 98 de novo PMLBCL patients over the last 20 years is reviewed. All patients received MACOP-B chemotherapy. Thirty-seven received both rituximab and mediastinal radiotherapy; 30 were irradiated after chemotherapy, although not receiving rituximab and 20 received rituximab without radiotherapy consolidation. Eleven patients received chemotherapy only.ResultsSixty-one (62.2%) patients achieved a complete response after MACOP-B (with or without rituximab); among the 27 (27.6%) partial responders, 21 obtained a complete response after radiotherapy. At the end of their scheduled treatment, 82 patients (83.7%) had a complete and 6 a partial response (6.1%). Eleven patients relapsed within the first 2 years of follow-up. The 17-year overall survival is 72.0% (15 patients died); progression-free and disease-free survival are 67.6% and 88.4%, respectively. A statistically significant difference in overall and progression-free survival was noted among treatment groups, although no disease-free survival difference was documented.ConclusionsOur data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. Mediastinal consolidation radiotherapy impacts on survival and complete response rates and remains a good strategy to convert partial into complete responses. Data suggest that radiotherapy may be avoided in patients obtaining a complete response after (immuno)chemotherapy, but this requires confirmation with further ad hoc studies.

【 授权许可】

CC BY   
© The Author(s). 2017