High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up
Abstract Primary mediastinal B-cell lymphoma (PMBL) is currently curable in 85–95% of patients. Treatment regimens frequently used include RCHOP ± radiotherapy, DAEPOCH-R, or occasionally more intensive protocols. Here we present results of treatment of 124 patients with PMBL over a period between 2...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-14067-3 |
| _version_ | 1828808711833911296 |
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| author | Joanna Romejko-Jarosinska Beata Ostrowska Anna Dabrowska-Iwanicka Katarzyna Domanska-Czyz Grzegorz Rymkiewicz Ewa Paszkiewicz-Kozik Robert Konecki Anna Borawska Agnieszka Druzd-Sitek Elzbieta Lampka Wlodzimierz Osiadacz Michal Osowiecki Lidia Popławska Monika Swierkowska Lukasz Targonski Joanna Tajer Grazyna Lapinska Malwina Smorczewska Jan Walewski |
| author_facet | Joanna Romejko-Jarosinska Beata Ostrowska Anna Dabrowska-Iwanicka Katarzyna Domanska-Czyz Grzegorz Rymkiewicz Ewa Paszkiewicz-Kozik Robert Konecki Anna Borawska Agnieszka Druzd-Sitek Elzbieta Lampka Wlodzimierz Osiadacz Michal Osowiecki Lidia Popławska Monika Swierkowska Lukasz Targonski Joanna Tajer Grazyna Lapinska Malwina Smorczewska Jan Walewski |
| author_sort | Joanna Romejko-Jarosinska |
| collection | DOAJ |
| description | Abstract Primary mediastinal B-cell lymphoma (PMBL) is currently curable in 85–95% of patients. Treatment regimens frequently used include RCHOP ± radiotherapy, DAEPOCH-R, or occasionally more intensive protocols. Here we present results of treatment of 124 patients with PMBL over a period between 2004 and 2017 with the use of a protocol designed for aggressive B-cell lymphoma GMALL/B-ALL/NHL2002 including 6 cycles of alternating immunochemotherapy with intermediate-dose methotrexate in each cycle, and reduced total doxorubicin dose (100 mg/m2 for whole treatment). Majority of patients (77%) received consolidative radiotherapy. A median (range) age of patients was 30 (18–59) years, and 60% were female. With a median (range) follow up of 9 (1–17) years, 5-year overall survival (OS) and 5-year progression free survival (PFS) were 94% and 92%, respectively. Positron emission tomography—computed tomography (PET-CT) results at the end of chemotherapy were predictive for outcome: OS and PFS at 5 year were 96% and 94% in PET-CT negative patients, respectively, and 70% and 70% in PET-CT-positive patients (p = 0.004 for OS, p = 0.01 for PFS). Eight (6%) patients had recurrent/refractory disease, however, no central nervous system (CNS) relapse was observed. Acute toxicity included pancytopenia grade 3/4, neutropenic fever, and treatment related mortality rate of 0.8%. Second malignancies and late cardiotoxicity occurred in 2.4% and 2.4% of patients, respectively. Intensive alternating immunochemotherapy protocol GMALL/B-ALL/NHL2002 is curative for more than 90% of PMBL patients and late toxicity in young patients is moderated. The attenuated dose of doxorubicin and intermediate dose of methotrexate may contribute to low incidence of late cardiotoxicity and effective CNS prophylaxis. |
| first_indexed | 2024-12-12T08:45:47Z |
| format | Article |
| id | doaj.art-390d2e0cb00f467e8bbd36aeef3cedd8 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-12T08:45:47Z |
| publishDate | 2022-06-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-390d2e0cb00f467e8bbd36aeef3cedd82022-12-22T00:30:32ZengNature PortfolioScientific Reports2045-23222022-06-0112111110.1038/s41598-022-14067-3High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow upJoanna Romejko-Jarosinska0Beata Ostrowska1Anna Dabrowska-Iwanicka2Katarzyna Domanska-Czyz3Grzegorz Rymkiewicz4Ewa Paszkiewicz-Kozik5Robert Konecki6Anna Borawska7Agnieszka Druzd-Sitek8Elzbieta Lampka9Wlodzimierz Osiadacz10Michal Osowiecki11Lidia Popławska12Monika Swierkowska13Lukasz Targonski14Joanna Tajer15Grazyna Lapinska16Malwina Smorczewska17Jan Walewski18Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Endocrine Oncology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Radiology, Maria Sklodowska-Curie National Research Institute of OncologyDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of OncologyAbstract Primary mediastinal B-cell lymphoma (PMBL) is currently curable in 85–95% of patients. Treatment regimens frequently used include RCHOP ± radiotherapy, DAEPOCH-R, or occasionally more intensive protocols. Here we present results of treatment of 124 patients with PMBL over a period between 2004 and 2017 with the use of a protocol designed for aggressive B-cell lymphoma GMALL/B-ALL/NHL2002 including 6 cycles of alternating immunochemotherapy with intermediate-dose methotrexate in each cycle, and reduced total doxorubicin dose (100 mg/m2 for whole treatment). Majority of patients (77%) received consolidative radiotherapy. A median (range) age of patients was 30 (18–59) years, and 60% were female. With a median (range) follow up of 9 (1–17) years, 5-year overall survival (OS) and 5-year progression free survival (PFS) were 94% and 92%, respectively. Positron emission tomography—computed tomography (PET-CT) results at the end of chemotherapy were predictive for outcome: OS and PFS at 5 year were 96% and 94% in PET-CT negative patients, respectively, and 70% and 70% in PET-CT-positive patients (p = 0.004 for OS, p = 0.01 for PFS). Eight (6%) patients had recurrent/refractory disease, however, no central nervous system (CNS) relapse was observed. Acute toxicity included pancytopenia grade 3/4, neutropenic fever, and treatment related mortality rate of 0.8%. Second malignancies and late cardiotoxicity occurred in 2.4% and 2.4% of patients, respectively. Intensive alternating immunochemotherapy protocol GMALL/B-ALL/NHL2002 is curative for more than 90% of PMBL patients and late toxicity in young patients is moderated. The attenuated dose of doxorubicin and intermediate dose of methotrexate may contribute to low incidence of late cardiotoxicity and effective CNS prophylaxis.https://doi.org/10.1038/s41598-022-14067-3 |
| spellingShingle | Joanna Romejko-Jarosinska Beata Ostrowska Anna Dabrowska-Iwanicka Katarzyna Domanska-Czyz Grzegorz Rymkiewicz Ewa Paszkiewicz-Kozik Robert Konecki Anna Borawska Agnieszka Druzd-Sitek Elzbieta Lampka Wlodzimierz Osiadacz Michal Osowiecki Lidia Popławska Monika Swierkowska Lukasz Targonski Joanna Tajer Grazyna Lapinska Malwina Smorczewska Jan Walewski High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up Scientific Reports |
| title | High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up |
| title_full | High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up |
| title_fullStr | High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up |
| title_full_unstemmed | High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up |
| title_short | High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up |
| title_sort | high efficacy of intensive immunochemotherapy for primary mediastinal b cell lymphoma with prolonged follow up |
| url | https://doi.org/10.1038/s41598-022-14067-3 |
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