Primary mediastinal large B-cell lymphoma (PMLBCL): Long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B

G. Todeschini, S. Secchi, E. Morra, U. Vitolo, E. Orlandi, F. Pasini, E. Gallo, A. Ambrosetti, C. Tecchio, C. Tarella, A. Gabbas, A. Gallamini, L. Gargantini, M. Pizzuti, G. Fioritoni, L. Gottin, G. Rossi, M. Lazzarino, F. Menestrina, M. PaulliM. Palestro, M. G. Cabras, F. Di Vito, G. Pizzolo

Research output: Contribution to journalArticle

Abstract

The optimal treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is still undefined. In the absence of randomised studies, we retrospectively analysed: (a) the effectiveness of two chemotherapy regimens (CHOP vs MACOP-B/VACOP-B) in complete remission (CR) achievement and event-free survival (EFS) and (b) the role of mediastinal involved-field radiotherapy (IF-RT) as consolidation. From 1982 to 1999, 138 consecutive patients affected by PMLBCL were treated in 13 Italian institutions with CHOP (43) or MACOP-B/VACOP-B (95), The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. Complete remission was 51.1% in the CHOP group and 80% in MACOP-B/VACOP-B (P <0.001). Relapse occurred in 22.7% of CHOP- and in 9.2% of MACOP-B/VACOP-B-treated patients (n.s.). Event-free patients were 39.5% in CHOP and 75.7% in the MACOP-B/VACOP-B group (P <0.001). The addition of IF-RT as consolidation improved the outcome, irrespectively of the type of chemotherapy (P = 0.04). At a multivariate analysis, achievement of CR (P <0.0001) and type of CT (MACOP-B/VACOP-B) retained the significance for OS (P = 0.008) and EFS (P = 0.03). In our experience, MACOP-B/VACOP-B appears to positively influence OS and EFS in patients affected by PMLBCL, as compared to CHOP. Consolidation IF-RT on mediastinum further improves the outcome of CR patients.

Original languageEnglish
Pages (from-to)372-376
Number of pages5
JournalBritish Journal of Cancer
Volume90
Issue number2
DOIs
Publication statusPublished - Jan 26 2004

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Keywords

  • CHOP
  • MACOP-B/VACOP-B
  • PMLBCL

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Todeschini, G., Secchi, S., Morra, E., Vitolo, U., Orlandi, E., Pasini, F., Gallo, E., Ambrosetti, A., Tecchio, C., Tarella, C., Gabbas, A., Gallamini, A., Gargantini, L., Pizzuti, M., Fioritoni, G., Gottin, L., Rossi, G., Lazzarino, M., Menestrina, F., ... Pizzolo, G. (2004). Primary mediastinal large B-cell lymphoma (PMLBCL): Long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B. British Journal of Cancer, 90(2), 372-376. https://doi.org/10.1038/sj.bjc.6601460