High-dose chemotherapy followed by autologous stem cell transplantation for relapsed/refractory primary mediastinal large B-cell lymphoma

Aoki, Tomohiro; Shimada, Kazuyuki; Suzuki, Ritsuro; Izutsu, Koji; Tomita, Akihiro; Maeda, Yoshinobu; Takizawa, Jun; Mitani, Kinuko; Igarashi, Tadahiko; Sakai, Katsuya; Miyazaki, Kana; Mihara, Keichiro; Ohmachi, Ken; Nakamura, Naoya; Takasaki, Hirotaka; Kiyoi, Hitoshi; Nakamura, Shigeo; Kinoshita, Tomohiro

doi:10.1038/bcj.2015.101

Cited by 43 publications

(38 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, most patients were able to proceed to HDT/ASCR. Notably, the EFS of transplanted patients was similar to existing reports showing an EFS of approximately 60% [26,27].…”

Section: Discussionsupporting

confidence: 86%

Outcomes of Relapsed and Refractory Primary Mediastinal (Thymic) Large B Cell Lymphoma Treated with Second-Line Therapy and Intent to Transplant

Vardhana

Hamlin

Yang

et al. 2018

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

Primary mediastinal (thymic) large B cell lymphoma is a subtype of diffuse large B cell lymphoma with distinct clinical, molecular, and genetic features, many of which overlap with Hodgkin lymphoma. Increasingly, initial therapy for these patients has used dose-dense chemotherapy with or without radiation with excellent results. In patients with relapsed and primary refractory disease, outcomes of second-line therapy followed by consolidation with high-dose therapy and autologous stem cell transplantation remains largely undefined. We reviewed the outcomes of 60 transplant-eligible patients with relapsed or refractory primary mediastinal (thymic) large B cell lymphoma enrolled on sequential protocols with uniform second-line therapy with intent to consolidate with autologous stem cell transplant. The estimated 3-year overall and event-free survivals for all patients were 61% and 57%, respectively, and 68% and 65%, respectively, for patients proceeding to stem cell transplant. Multivariable analysis of risk factors before transplant revealed that an incomplete response to initial therapy, advanced Ann Arbor stage at disease progression, and failure to achieve a partial remission or better to second-line therapy to be independently associated with inferior event-free and overall survival. A risk score based on these variables was able to identify patients who are unlikely to respond to conventional second-line strategies. These results suggest that salvage chemoradiotherapy with intent of subsequent high-dose therapy and autologous stem cell transplant is successful in most patients with relapsed and refractory primary mediastinal (thymic) large B cell lymphoma. Alternative strategies are warranted for a significant subset of patients with high-risk disease who are unlikely to be cured with this strategy.

show abstract

“…As a result, most patients were able to proceed to HDT/ASCR. Notably, the EFS of transplanted patients was similar to existing reports showing an EFS of approximately 60% [26,27].…”

Section: Discussionsupporting

confidence: 86%

Outcomes of Relapsed and Refractory Primary Mediastinal (Thymic) Large B Cell Lymphoma Treated with Second-Line Therapy and Intent to Transplant

Vardhana

Hamlin

Yang

et al. 2018

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

show abstract

“…As reported in the DA-EPOCH-R prospective study, if the patient has localised disease and is RT-na€ ıve then RT alone can be curative (Dunleavy et al, 2013). The usual alternative is salvage immunochemotherapy followed by high-dose chemotherapy and ASCT, as in DLBCL (Aoki et al, 2015;Kuruvilla et al, 2008). Salvage immunochemotherapy regimens include R-DHAP (rituximab, dexamethasone, cytarabine, cisplatin), R-ICE (rituximab, ifosfamide, carboplatin and etoposide) (Gisselbrecht et al, 2010) or the potentially less toxic R-GDP (rituximab, gemcitabine, dexamethasone, cisplatin) (Crump et al, 2014).…”

Section: Relapsed/refractory Diseasementioning

confidence: 99%

Biology and therapy of primary mediastinal B‐cell lymphoma: current status and future directions

et al. 2019

View full text Add to dashboard Cite

Summary Primary mediastinal B‐cell lymphoma ( PMBCL ) is a distinct disease closely related to classical nodular sclerosing Hodgkin lymphoma. Conventional diagnostic paradigms utilising clinical, morphological and immunophenotypical features can be challenging due to overlapping features with other B‐cell lymphomas. Reliable diagnostic and prognostic biomarkers that are applicable to the conventional diagnostic laboratory are largely lacking. Nuclear factor kappa B ( NF ‐κB) and Janus kinase/signal transducers and activators of transcription ( JAK ‐ STAT ) signalling pathways are characteristically dysregulated in PMBCL and implicated in several aspects of disease pathogenesis, and the latter pathway in host immune evasion. The tumour microenvironment is manipulated by PMBCL tumours to avoid T‐cell mediated destruction via strategies that include loss of tumour cell antigenicity, T‐cell exhaustion and activation of suppressive T‐regulatory cells. R‐ CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) and DA ‐ EPOCH ‐R (dose‐adjusted etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin, rituximab) are the most common first‐line immunochemotherapy regimens. End of treatment positron emission tomography scans are the recommended imaging modality and are being evaluated to stratify patients for radiotherapy. Relapsed/refractory disease has a relatively poor outcome despite salvage immunochemotherapy and subsequent autologous stem cell transplantation. Novel therapies are therefore being developed for treatment‐resistant disease, targeting aberrant cellular signalling and immune evasion.

show abstract

“…12 Clearance of antibody-bound tumor cells in the liver through antibody-dependent phagocytosis by Kupffer cells is well documented for several antibody-based therapeutics. 13,14 Thus, ADCs, bound or unbound to their target antigen, may be taken up by Kupffer cells via Fc receptors, resulting in liver-dominant off-target delivery of the antineoplastic molecule. In a similar fashion, sinusoidal endothelial cells avidly take up immunoglobulins through endocytic pathways.…”

mentioning

confidence: 99%

Brentuximab vedotin in relapsed primary mediastinal large B-cell lymphoma: results from a phase 2 clinical trial

Zinzani

Pellegrini

Chiappella³

et al. 2017

Blood

View full text Add to dashboard Cite

High-dose chemotherapy followed by autologous stem cell transplantation for relapsed/refractory primary mediastinal large B-cell lymphoma

Cited by 43 publications

References 14 publications

Outcomes of Relapsed and Refractory Primary Mediastinal (Thymic) Large B Cell Lymphoma Treated with Second-Line Therapy and Intent to Transplant

Outcomes of Relapsed and Refractory Primary Mediastinal (Thymic) Large B Cell Lymphoma Treated with Second-Line Therapy and Intent to Transplant

Biology and therapy of primary mediastinal B‐cell lymphoma: current status and future directions

Brentuximab vedotin in relapsed primary mediastinal large B-cell lymphoma: results from a phase 2 clinical trial

Contact Info

Product

Resources

About