The role of rituximab and positron emission tomography in the treatment of primary mediastinal large B-cell lymphoma: Experience on 74 patients

Pier Luigi Zinzani, Alessandro Broccoli, Beatrice Casadei, Vittorio Stefoni, Cinzia Pellegrini, Letizia Gandolfi, Roberto Maglie, Lisa Argnani, Stefano Pileri, Stefano Fanti

Research output: Contribution to journalArticle

Abstract

Regarding primary mediastinal large B-cell lymphoma (PMLBCL), there are several controversial topics that warrant further investigation: the superiority of third-generation regimens, the impact of rituximab, the use of involved field radiotherapy (RT) and the assessment of clinical response by positron emission tomography (PET). We report our experience on 74 PMLBCL patients treated with a combination of a third-generation chemotherapy regimen (MACOP-B) and rituximab: an observational retrospective single-centre study was conducted on patients diagnosed and treated between February 2002 and July 2011. All patients were evaluated by computed tomography scan and PET scan; after the final PET evaluation, PET-negative patients were observed, whereas PET-positive patients underwent mediastinal RT. Sixty-one (82.4%) patients achieved a complete response after the MACOP-B plus rituximab regimen; 68.9% presented a positive final PET and were treated with local RT, whereas 31.1% had a negative PET. Five patients relapsed within 12months. At 10years, overall survival was 82%, progression-free survival was 87.6% and disease-free survival (DFS) was 90.5% (median follow-up 4years). No statistically significant differences were observed in DFS between the patients treated also with RT (PET positive) and patients only observed (PET negative): 90.7% vs 90% (p=0.85), respectively. In our experience, adding rituximab does not change the final results in terms of complete response and DFS utilizing third-generation regimen. Furthermore, the introduction of the PET-guided RT approach leads to a patient-tailored treatment, which preserves the outcome and, at the same time, allows reducing the use of RT.

Original languageEnglish
Pages (from-to)145-150
Number of pages6
JournalHematological Oncology
Volume33
Issue number4
DOIs
Publication statusPublished - Dec 1 2015

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Keywords

  • MACOP-B regimen
  • PET scan
  • PMLBCL
  • Radiotherapy
  • Rituximab

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Zinzani, P. L., Broccoli, A., Casadei, B., Stefoni, V., Pellegrini, C., Gandolfi, L., Maglie, R., Argnani, L., Pileri, S., & Fanti, S. (2015). The role of rituximab and positron emission tomography in the treatment of primary mediastinal large B-cell lymphoma: Experience on 74 patients. Hematological Oncology, 33(4), 145-150. https://doi.org/10.1002/hon.2172