Outcomes of adults and children with primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-R

Lisa Giulino-Roth; Tara O'Donohue; Zhengming Chen; Nancy L. Bartlett; Ann LaCasce; William Martin-Doyle; Matthew J. Barth; Kimberly Davies; Kristie A. Blum; Beth Christian; Carla Casulo; Sonali M. Smith; James Godfrey; Amanda Termuhlen; Matthew J. Oberley; Sarah Alexander; Sheila Weitzman; Burton Appel; Benjamin Mizukawa; Jakub Svoboda; Zeinab Afify; Melinda Pauly; Hema Dave; Rebecca Gardner; Deborah M. Stephens; William A. Zeitler; Christopher Forlenza; Jennifer Levine; Michael E. Williams; Jody L. Sima; Catherine M. Bollard; John P. Leonard

doi:10.1111/bjh.14951

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Outcomes of adults and children with primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-R

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Outcomes of adults and children with primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-R

Lisa Giulino-Roth, Tara O'Donohue, Zhengming Chen, Nancy L. Bartlett, Ann LaCasce, William Martin-Doyle, Matthew J. Barth, Kimberly Davies, Kristie A. Blum, Beth Christian, …

British journal of haematology, Vol.179(5), pp.739-747

12/01/2017

DOI: 10.1111/bjh.14951

PMCID: PMC6650639

PMID: 29082519

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Abstract

Treatment with dose-adjusted EPOCH (etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone) chemotherapy and rituximab (DA-EPOCH-R) has become the standard of care for primary mediastinal B-cell lymphoma (PMBCL) at many institutions despite limited data in the multi-centre setting. We report a large, multi-centre retrospective analysis of children and adults with PMBCL treated with DA-EPOCH-R to characterize outcomes and evaluate prognostic factors. We assessed 156 patients with PMBCL treated with DA-EPOCH-R across 24 academic centres, including 38 children and 118 adults. All patients received at least one cycle of DA-EPOCH-R. Radiation therapy was administered in 14.9% of patients. With median follow-up of 22.6 months, the estimated 3-year event-free survival (EFS) was 85.9% [95% confidence interval (CI) 80.3-91.5] and overall survival was 95.4% (95% CI 91.8-99.0). Outcomes were not statistically different between paediatric and adult patients. Thrombotic complications were reported in 28.2% of patients and were more common in paediatric patients (45.9% vs. 22.9%, P = 0.011). Seventy-five per cent of patients had a negative fluorodeoxyglucose positron emission tomography (FDG-PET) scan at the completion of DA-EPOCH-R, defined as Deauville score 1-3. Negative FDG-PET at end-of-therapy was associated with improved EFS (95.4% vs. 54.9%, P < 0.001). Our data support the use of DA-EPOCH-R for the treatment of PMBCL in children and adults. Patients with a positive end-of-therapy FDG-PET scan have an inferior outcome.

Hematology

Life Sciences & Biomedicine

Science & Technology

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Title: Subtitle: Outcomes of adults and children with primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-R
Creators: Lisa Giulino-Roth - Weill Cornell Medicine
Tara O'Donohue - Weill Cornell Medicine
Zhengming Chen - Weill Cornell Medicine
Nancy L. Bartlett - Washington University in St. Louis
Ann LaCasce - Dana-Farber Cancer Institute
William Martin-Doyle - Brigham and Women's Hospital
Matthew J. Barth - Roswell Park Cancer Institute
Kimberly Davies - Dana-Farber Cancer Institute
Kristie A. Blum - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Beth Christian - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Carla Casulo - University of Rochester Medical Center
Sonali M. Smith - University of Chicago
James Godfrey - University of Chicago
Amanda Termuhlen - Keck Hospital of USC
Matthew J. Oberley - Children's Hospital of Los Angeles
Sarah Alexander - Hospital for Sick Children
Sheila Weitzman - Hospital for Sick Children
Burton Appel - Hackensack University Medical Center
Benjamin Mizukawa - Cincinnati Children's Hospital Medical Center
Jakub Svoboda - University of Pennsylvania
Zeinab Afify - University of Utah
Melinda Pauly - Emory University
Hema Dave - George Washington University
Rebecca Gardner - Seattle Children's Hospital
Deborah M. Stephens - University of Utah
William A. Zeitler - University of Iowa
Christopher Forlenza - Memorial Sloan Kettering Cancer Center
Jennifer Levine - Columbia University Irving Medical Center
Michael E. Williams - University of Virginia
Jody L. Sima - SUNY Upstate Medical University
Catherine M. Bollard - George Washington University
John P. Leonard - Weill Cornell Medicine
Resource Type: Journal article
Publication Details: British journal of haematology, Vol.179(5), pp.739-747
Publisher: Wiley
DOI: 10.1111/bjh.14951
PMID: 29082519
PMCID: PMC6650639
ISSN: 0007-1048
eISSN: 1365-2141
Number of pages: 9
Grant note: Lymphoma Foundation K08CA219473 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) St. Baldrick's Foundation Hyundai Hope on Wheels
Language: English
Date published: 12/01/2017
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984359770002771

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