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Dose-densified chemoimmunotherapy followed by systemic central nervous system prophylaxis for younger high-risk diffuse large B-cell/follicular grade 3 lymphoma patients: results of a phase II Nordic Lymphoma Group study

Holte, H.; Leppa, S.; Bjorkholm, M.; Fluge, O.; Jyrkkio, S.; Delabie, J.; Sundstrom, C.; Karjalainen-Lindsberg, M. -L.; Erlanson, M. and Kolstad, A., et al. (2013) In Annals of Oncology 24(5). p.1385-1392
Abstract
Background: Many patients with aggressive B-cell lymphomas and high clinical risk score still die of lymphoma after conventional R-CHOP chemoimmunotherapy. We hypothesized that intensified chemoimmunotherapy including systemic central nervous system (CNS) prophylaxis improves outcome and reduces the incidence of CNS-related events. Patients and methods: Inclusion criteria were age 18-65 years, primary diffuse large B-cell lymphoma or grade III follicular lymphoma without clinical signs of CNS disease and negative cerebrospinal fluid cytology, age-adjusted International Prognostic Index 2-3 and WHO performance score 0-3. Treatment consisted of six courses of R-CHOEP-14 followed by a course of high-dose cytarabine and a course of high-dose... (More)
Background: Many patients with aggressive B-cell lymphomas and high clinical risk score still die of lymphoma after conventional R-CHOP chemoimmunotherapy. We hypothesized that intensified chemoimmunotherapy including systemic central nervous system (CNS) prophylaxis improves outcome and reduces the incidence of CNS-related events. Patients and methods: Inclusion criteria were age 18-65 years, primary diffuse large B-cell lymphoma or grade III follicular lymphoma without clinical signs of CNS disease and negative cerebrospinal fluid cytology, age-adjusted International Prognostic Index 2-3 and WHO performance score 0-3. Treatment consisted of six courses of R-CHOEP-14 followed by a course of high-dose cytarabine and a course of high-dose methotrexate. Primary end point was failure-free survival (FFS) at 3 years. Results: A total of 156 eligible patients with a median age of 54 years (range 20-64) were included. Three toxic deaths were observed. Three-year overall survival (OS) and FFS rates (median observation time 52 months for survivors) were 81% and 65%, respectively. Seven patients experienced CNS relapse, all within 6 months. Conclusions: The results are promising with favorable 3-year OS and FFS rates, a low toxic death rate and a lower than expected number of CNS events. CNS progression might be further reduced by earlier CNS prophylaxis. CinicalTrials.gov.identifier: NCT01502982. (Less)
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published
subject
keywords
age-adjusted IPI, central nervous system, diffuse large B-cell lymphoma, intensive chemotherapy, prophylaxis
in
Annals of Oncology
volume
24
issue
5
pages
1385 - 1392
publisher
Oxford University Press
external identifiers
  • wos:000318105000034
  • scopus:84877116726
ISSN
1569-8041
DOI
10.1093/annonc/mds621
language
English
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yes
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000cef2f-5648-45f1-b42c-9f31960f05f1 (old id 3843319)
date added to LUP
2013-07-01 07:01:07
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2019-06-16 04:09:42
@article{000cef2f-5648-45f1-b42c-9f31960f05f1,
  abstract     = {Background: Many patients with aggressive B-cell lymphomas and high clinical risk score still die of lymphoma after conventional R-CHOP chemoimmunotherapy. We hypothesized that intensified chemoimmunotherapy including systemic central nervous system (CNS) prophylaxis improves outcome and reduces the incidence of CNS-related events. Patients and methods: Inclusion criteria were age 18-65 years, primary diffuse large B-cell lymphoma or grade III follicular lymphoma without clinical signs of CNS disease and negative cerebrospinal fluid cytology, age-adjusted International Prognostic Index 2-3 and WHO performance score 0-3. Treatment consisted of six courses of R-CHOEP-14 followed by a course of high-dose cytarabine and a course of high-dose methotrexate. Primary end point was failure-free survival (FFS) at 3 years. Results: A total of 156 eligible patients with a median age of 54 years (range 20-64) were included. Three toxic deaths were observed. Three-year overall survival (OS) and FFS rates (median observation time 52 months for survivors) were 81% and 65%, respectively. Seven patients experienced CNS relapse, all within 6 months. Conclusions: The results are promising with favorable 3-year OS and FFS rates, a low toxic death rate and a lower than expected number of CNS events. CNS progression might be further reduced by earlier CNS prophylaxis. CinicalTrials.gov.identifier: NCT01502982.},
  author       = {Holte, H. and Leppa, S. and Bjorkholm, M. and Fluge, O. and Jyrkkio, S. and Delabie, J. and Sundstrom, C. and Karjalainen-Lindsberg, M. -L. and Erlanson, M. and Kolstad, A. and Fossa, A. and Ostenstad, B. and Lofvenberg, E. and Nordstrom, M. and Janes, R. and Pedersen, L. M. and Anderson, Harald and Jerkeman, Mats and Eriksson, Mikael},
  issn         = {1569-8041},
  keyword      = {age-adjusted IPI,central nervous system,diffuse large B-cell lymphoma,intensive chemotherapy,prophylaxis},
  language     = {eng},
  number       = {5},
  pages        = {1385--1392},
  publisher    = {Oxford University Press},
  series       = {Annals of Oncology},
  title        = {Dose-densified chemoimmunotherapy followed by systemic central nervous system prophylaxis for younger high-risk diffuse large B-cell/follicular grade 3 lymphoma patients: results of a phase II Nordic Lymphoma Group study},
  url          = {http://dx.doi.org/10.1093/annonc/mds621},
  volume       = {24},
  year         = {2013},
}