Outcomes of Patients With Double-Hit Lymphoma Who Achieve First Complete Remission
-
Published:2017-07-10
Issue:20
Volume:35
Page:2260-2267
-
ISSN:0732-183X
-
Container-title:Journal of Clinical Oncology
-
language:en
-
Short-container-title:JCO
Author:
Landsburg Daniel J.1, Falkiewicz Marissa K.1, Maly Joseph1, Blum Kristie A.1, Howlett Christina1, Feldman Tatyana1, Mato Anthony R.1, Hill Brian T.1, Li Shaoying1, Medeiros L. Jeffrey1, Torka Pallawi1, Hernandez-Ilizaliturri Francisco1, Reddy Nishitha M.1, Singavi Arun1, Fenske Timothy S.1, Chavez Julio C.1, Kaplan Jason B.1, Behdad Amir1, Petrich Adam M.1, Bast Martin A.1, Vose Julie M.1, Olszewski Adam J.1, Costa Cristiana1, Lansigan Frederick1, Gerson James N.1, Barta Stefan K.1, Calzada Oscar1, Cohen Jonathon B.1, Lue Jennifer K.1, Amengual Jennifer E.1, Rivera Xavier1, Persky Daniel O.1, Peace David J.1, Nathan Sunita1, Cassaday Ryan D.1
Affiliation:
1. Daniel J. Landsburg and Anthony R. Mato, University of Pennsylvania; James N. Gerson and Stefan K. Barta, Temple University, Philadelphia, PA; Marissa K. Falkiewicz, Robert Wood Johnson Medical School, New Brunswick; Christina Howlett, Tatyana Feldman, and Anthony R. Mato, Hackensack University Medical Center, Hackensack, NJ; Joseph Maly and Kristie A. Blum, Ohio State University, Columbus; Brian T. Hill, Cleveland Clinic, Cleveland, OH; Shaoying Li and L. Jeffrey Medeiros, MD Anderson Cancer Center,...
Abstract
Purpose Patients with double-hit lymphoma (DHL) rarely achieve long-term survival following disease relapse. Some patients with DHL undergo consolidative autologous stem-cell transplantation (autoSCT) to reduce the risk of relapse, although the benefit of this treatment strategy is unclear. Methods Patients with DHL who achieved first complete remission following completion of front-line therapy with either rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or intensive front-line therapy, and deemed fit for autoSCT, were included. A landmark analysis was performed, with time zero defined as 3 months after completion of front-line therapy. Patients who experienced relapse before or who were not followed until that time were excluded. Results Relapse-free survival (RFS) and overall survival (OS) rates at 3 years were 80% and 87%, respectively, for all patients (n = 159). Three-year RFS and OS rates did not differ significantly for autoSCT (n = 62) versus non-autoSCT patients (n = 97), but 3-year RFS was inferior in patients who received R-CHOP compared with intensive therapy (56% v 88%; P = .002). Three-year RFS and OS did not differ significantly for patients in the R-CHOP or intensive therapy cohorts when analyzed by receipt of autoSCT. The median OS following relapse was 8.6 months. Conclusion In the largest reported series, to our knowledge, of patients with DHL to achieve first complete remission, consolidative autoSCT was not associated with improved 3-year RFS or OS. In addition, patients treated with R-CHOP experienced inferior 3-year RFS compared with those who received intensive front-line therapy. When considered in conjunction with reports of patients with newly diagnosed DHL, which demonstrate lower rates of disease response to R-CHOP compared with intensive front-line therapy, our findings further support the use of intensive front-line therapy for this patient population.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Cited by
124 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|