Impact of immunochemotherapy regimens on outcomes of patients with primary mediastinal B-cell lymphoma in the IELSG37 trial
(2025) In Blood- Abstract
The IELSG37 trial enrolled 545 patients with primary mediastinal B-cell lymphoma (PMBCL) and demonstrated that consolidation radiotherapy (RT) can be omitted in patients with complete metabolic response, defined by the Lugano classification as Deauville score (DS) 1 to 3. This report evaluates outcomes after different frontline rituximab- and doxorubicin-based immunochemotherapy regimens chosen according to local practice. Patients treated with R-CHOP21 (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone, administered every 21 days) showed a significantly higher percentage of DS 5 than those on other regimens (23.8% vs 8.2% average; P < .001) and a trend toward additional unplanned treatments (53.2% vs 46.9%; P =... (More)
The IELSG37 trial enrolled 545 patients with primary mediastinal B-cell lymphoma (PMBCL) and demonstrated that consolidation radiotherapy (RT) can be omitted in patients with complete metabolic response, defined by the Lugano classification as Deauville score (DS) 1 to 3. This report evaluates outcomes after different frontline rituximab- and doxorubicin-based immunochemotherapy regimens chosen according to local practice. Patients treated with R-CHOP21 (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone, administered every 21 days) showed a significantly higher percentage of DS 5 than those on other regimens (23.8% vs 8.2% average; P < .001) and a trend toward additional unplanned treatments (53.2% vs 46.9%; P = .30). The increased risk of poor response was confirmed in a multinomial logistic regression analysis adjusted for age, sex, international prognostic index score, and performance status. R-CHOP21 was also associated with smaller reductions in metabolic tumor volume and less pronounced decreases in maximum standardized uptake value. Patients with DS 5 more often received additional treatment (RT and/or salvage chemotherapy with or without autologous consolidation) after induction immunochemotherapy (96% vs 41%; P < .001) and experienced significantly poorer outcomes. Although differences in progression-free and overall survival between R-CHOP21 and more aggressive regimens were not statistically significant, R-CHOP21 may increase the risk of additional treatments and may be inadvisable as frontline therapy for PMBCL. This trial was registered atwww.clinicaltrials.govas #NCT01599559.
(Less)
- author
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Blood
- publisher
- American Society of Hematology
- external identifiers
-
- scopus:105021045807
- pmid:40939190
- ISSN
- 0006-4971
- DOI
- 10.1182/blood.2025028823
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
- id
- 66706db0-2fa7-426e-9e39-e40f76d84f95
- date added to LUP
- 2026-01-13 08:52:37
- date last changed
- 2026-01-27 10:11:27
@article{66706db0-2fa7-426e-9e39-e40f76d84f95,
abstract = {{<p>The IELSG37 trial enrolled 545 patients with primary mediastinal B-cell lymphoma (PMBCL) and demonstrated that consolidation radiotherapy (RT) can be omitted in patients with complete metabolic response, defined by the Lugano classification as Deauville score (DS) 1 to 3. This report evaluates outcomes after different frontline rituximab- and doxorubicin-based immunochemotherapy regimens chosen according to local practice. Patients treated with R-CHOP21 (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone, administered every 21 days) showed a significantly higher percentage of DS 5 than those on other regimens (23.8% vs 8.2% average; P < .001) and a trend toward additional unplanned treatments (53.2% vs 46.9%; P = .30). The increased risk of poor response was confirmed in a multinomial logistic regression analysis adjusted for age, sex, international prognostic index score, and performance status. R-CHOP21 was also associated with smaller reductions in metabolic tumor volume and less pronounced decreases in maximum standardized uptake value. Patients with DS 5 more often received additional treatment (RT and/or salvage chemotherapy with or without autologous consolidation) after induction immunochemotherapy (96% vs 41%; P < .001) and experienced significantly poorer outcomes. Although differences in progression-free and overall survival between R-CHOP21 and more aggressive regimens were not statistically significant, R-CHOP21 may increase the risk of additional treatments and may be inadvisable as frontline therapy for PMBCL. This trial was registered atwww.clinicaltrials.govas #NCT01599559.</p>}},
author = {{Zucca, Emanuele and Ceriani, Luca and Ciccone, Giovannino and Di Rocco, Alice and Pirosa, Maria Cristina and Kriachok, Iryna and Botto, Barbara and Balzarotti, Monica and Tucci, Alessandra and Usai, Sara Veronica and Zilioli, Vittorio Ruggero and Pennese, Elsa and Arcaini, Luca and Dabrowska-Iwanicka, Anna and Ferreri, Andrés J.M. and Merli, Francesco and Zhao, Weili and Rigacci, Luigi and Cellini, Claudia and Hodgson, David and Ionescu, Codruta and Minoia, Carla and Lucchini, Elisa and Spina, Michele and Fosså, Alexander and Janikova, Andrea and Cwynarski, Kate and Mikhaeel, N. George and Jerkeman, Mats and Stathis, Anastasios and Cozens, Kelly and Ielmini, Nicoletta and De Martino, Iolanda and Walewski, Jan and Trneny, Marek and Cavalli, Franco and Ricardi, Umberto and Johnson, Peter W.M. and Davies, Andrew and Martelli, Maurizio}},
issn = {{0006-4971}},
language = {{eng}},
publisher = {{American Society of Hematology}},
series = {{Blood}},
title = {{Impact of immunochemotherapy regimens on outcomes of patients with primary mediastinal B-cell lymphoma in the IELSG37 trial}},
url = {{http://dx.doi.org/10.1182/blood.2025028823}},
doi = {{10.1182/blood.2025028823}},
year = {{2025}},
}