Primary mediastinal large cell lymphoma (PMBL): frontline treatment with autologous stem cell transplantation (ASCT). The GEL-TAMO experience

Hematological Oncology
José RodríguezMaría Dolores Caballero

Abstract

Given the excellent results obtained with present new induction regimens in PMBL, the role of frontline ASCT is controversial. We present 71 patients with PMBL receiving induction chemotherapy, followed by ASCT as frontline therapy from the GEL-TAMO registry. Most patients presented with high-risk clinical features. At transplant, 49% of patients were in CR, 32% in PR and 18% failed induction therapy; 53% received radiotherapy. After the transplant 75% of patients achieved CR. With a median follow-up of 52.5 months, the OS, PFS and DFS at 4 years from diagnosis were, respectively, 84%, 81% and 81% for the first CR patients and 49%, 42% and 82% for the induction failure (PR and refractory) patients. Disease progression was the main cause of death (79%). By multivariate survival analysis the tumour score, refractory disease at transplant and radiotherapy were independent variables associated with OS and PFS. Our experience, with a prolonged follow-up, shows that patients with PMBL presenting at diagnosis with high-risk features or PR response to induction therapy have an encouraging survival with frontline ASCT. However, patients who received the transplant after failing the induction regimen have a very poor prognosis and should...Continue Reading

References

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Citations

Jul 27, 2011·Current Oncology Reports·Pier Luigi Zinzani, Pier Paolo Piccaluga
Jun 22, 2014·Current Hematologic Malignancy Reports·Anna Dabrowska-Iwanicka, Jan A Walewski
Jun 28, 2011·Blood·Christian Steidl, Randy D Gascoyne
Apr 12, 2014·Blood Research·Heui June AhnCheolwon Suh
Feb 1, 2009·Expert Review of Hematology·Xavier Poiré, Koen van Besien
Dec 17, 2008·Hematology·Peter W M Johnson, Andrew J Davies
Nov 20, 2015·American Journal of Clinical Oncology·Bouthaina S DabajaLouis S Constine
Dec 30, 2014·Expert Review of Hematology·Maurizio MartelliRobin Foà
Jun 18, 2018·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Santosha VardhanaCraig H Moskowitz

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