MACOP-B treatment in diffuse large-cell lymphoma: identification of prognostic groups in an Italian multicenter study.

Vitolo, Umberto; Bertini, M; Brusamolino, Ercole; Cavallero, Giobatta; Comotti, B; Gallo, Eugenio; Ghio, Riccardo; Levis, Alessandro; Luxi, G.; Meneghini, Vittorio

doi:10.1200/jco.1992.10.2.219

Cited by 43 publications

(22 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies [3][4][5][6][7][8][9] (although not all studies 1,15 ) have reported that bulky disease is an adverse prognostic factor in patients with aggressive lymphomas. Surgery may play a role in the management of such patients by removing malignant cells that are resistant to chemotherapy and radiotherapy and that eventually may give rise to distant metastases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Results with chemotherapy comprised of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by radiotherapy with or without prechemotherapy surgical debulking for patients with bulky, aggressive lymphoma

Wilder

Romaguera

Tucker

et al. 2002

Cancer

View full text Add to dashboard Cite

BACKGROUNDThe authors performed a case–control analysis of local control, progression free survival, and overall survival in patients with Stage I–II aggressive lymphomas measuring ≥ 7 cm in greatest dimension who were treated initially with or without surgical debulking: All patients then received cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)‐based chemotherapy followed by involved‐field radiotherapy.METHODSFrom May 1975 through May 1996, 50 patients were treated with (n = 25 patients) or without (n = 25 patients) resection of > 80% of their bulky lymphomas. Chemotherapy consisted of 3–12 cycles of CHOP. In general, patients who underwent debulking received three cycles of chemotherapy, whereas patients who did not undergo debulking received at least six cycles of chemotherapy. The total radiotherapy dose was 40.8 grays (Gy) ± 4.2 Gy (mean ± standard deviation).RESULTSThe median follow‐up was 62 months. Patients who underwent debulking were similar prognostically to patients who did not. There was a trend toward improved local control (5‐year rates: 96% vs. 80%; P = 0.10) and overall survival (5‐year rates: 83% vs. 71%; P = 0.18) in patients who underwent debulking compared with patients who did not, respectively. Progression free survival was significantly better for patients who underwent debulking compared with patients who did not (5‐year rates: 88% vs. 62%, respectively; P = 0.04).CONCLUSIONSBecause this study was retrospective, selection bias may account for the observed difference in progression free survival. Because it is unlikely that a trial randomizing patients with bulky, aggressive lymphoma to surgery will be conducted, the authors' current efforts are focused on escalation of the total radiotherapy dose as a possibly less costly and less morbid approach toward improving progression free survival for these patients. Cancer 2002;94:601–5. © 2002 American Cancer Society.DOI 10.1002/cncr.10260

show abstract

Section: Discussionmentioning

confidence: 99%

“…1 The IPI includes independent prognostic features, such as age and serum lactate dehydrogenase (LDH) level. A number of groups have suggested that T-cell phenotype, 2 bulky disease, [3][4][5][6][7][8][9] and total radiotherapy dose 10 also are important prognostically.…”

mentioning

confidence: 99%

Results with chemotherapy comprised of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by radiotherapy with or without prechemotherapy surgical debulking for patients with bulky, aggressive lymphoma

Wilder

Romaguera

Tucker

et al. 2002

Cancer

View full text Add to dashboard Cite

show abstract

“…BM involvement has also been reported as an adverse prognostic feature in DLCL, especially if associated with intermediate/high IPI scores. [51][52][53] In our series, 23 out of 35 patients with BM involvement are now in continuous CR and it is quite likely that, here too, rituximab played a major role in this particular setting. Finally, a favorable outcome was also obtained in the subgroup of patients with DLB-CL and ABC phenotype, a phenotypic subgroup characterized by a reduced response to both conventional and intensified approaches.…”

Section: Tablementioning

confidence: 98%

Prolonged survival in poor-risk diffuse large B-cell lymphoma following front-line treatment with rituximab-supplemented, early-intensified chemotherapy with multiple autologous hematopoietic stem cell support: a multicenter study by GITIL (Gruppo Italiano Terapie Innovative nei Linfomi)

et al. 2007

View full text Add to dashboard Cite

A prospective multicenter program was performed to evaluate the combination of rituximab and high-dose (hd) sequential chemotherapy delivered with multiple autologous peripheral blood progenitor cell (PBPC) support (R-HDS-maps regimen) in previously untreated patients with diffuse large B-cell lymphoma (DLB-CL) and age-adjusted International Prognostic Score (aaIPI) score 2-3. R-HDS-maps includes: (i) three APO courses; (ii) sequential administration of hd-cyclophosphamide (CY), hd-Ara-C, both supplemented with rituximab, hd-etoposide/ cisplatin, PBPC harvests, following hd-CY and hd-Ara-C; (iii) hd-mitoxantrone (hd-Mito)/L-Pam þ 2 further rituximab doses; (iv) involved-field radiotherapy. PBPC rescue was scheduled following Ara-C, etoposide/cisplatin and Mito/L-Pam. Between 1999 and 2004, 112 consecutive patients aged o65 years (74 score 2, 38 score 3) entered the study protocol. There were five early and two late toxic deaths. Overall 90 patients (80%) reached clinical remission (CR); at a median 48 months followup, 87 (78%) patients are alive, 82 (73%) in continuous CR, with 4 year overall survival (OS) and event-free survival (EFS) projections of 76% (CI 68-85%) and 73% (CI 64-81%), respectively. There were no significant differences in OS and EFS between subgroups with Germinal-Center and Activated B-cell phenotype. Thus, life expectancy of younger patients with aaIPI 2-3 DLB-CL is improved with the early administration of rituximab-supplemented intensive chemotherapy compared with the poor outcome following conventional chemotherapy.

show abstract

“…Specific sites of tumour involvement, especially the bone marrow, but also other sites such as the gastrointestinal tract, have been identified as significant adverse prognostic factors. 26 Some extranodal sites, such as brain 27 or testis, 28 require special treatment strategies, and DLBCL which have arisen in those sites constitute particularly aggressive malignancies (see the section 'Aggressiveness indicators', below). Response rate after primary treatment is highly predictive of outcome.…”

Section: Tumour-related Variablesmentioning

confidence: 99%

Rituximab (MabThera®) for aggressive non-Hodgkin's lymphoma: systematic review and economic evaluation

Knight

Hind²,

Brewer³

et al. 2004

Health Technol Assess

View full text Add to dashboard Cite

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. NHS R&D HTA ProgrammeT he research findings from the NHS R&D Health Technology Assessment (HTA) Programme directly influence key decision-making bodies such as the National Institute for Clinical Excellence (NICE) and the National Screening Committee (NSC) who rely on HTA outputs to help raise standards of care. HTA findings also help to improve the quality of the service in the NHS indirectly in that they form a key component of the 'National Knowledge Service' that is being developed to improve the evidence of clinical practice throughout the NHS.The HTA Programme was set up in 1993. Its role is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care.The HTA programme commissions research only on topics where it has identified key gaps in the evidence needed by the NHS. Suggestions for topics are actively sought from people working in the NHS, the public, consumer groups and professional bodies such as Royal Colleges and NHS Trusts.Research suggestions are carefully considered by panels of independent experts (including consumers) whose advice results in a ranked list of recommended research priorities. The HTA Programme then commissions the research team best suited to un...

show abstract

MACOP-B treatment in diffuse large-cell lymphoma: identification of prognostic groups in an Italian multicenter study.

Cited by 43 publications

References 15 publications

Results with chemotherapy comprised of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by radiotherapy with or without prechemotherapy surgical debulking for patients with bulky, aggressive lymphoma

Results with chemotherapy comprised of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by radiotherapy with or without prechemotherapy surgical debulking for patients with bulky, aggressive lymphoma

Prolonged survival in poor-risk diffuse large B-cell lymphoma following front-line treatment with rituximab-supplemented, early-intensified chemotherapy with multiple autologous hematopoietic stem cell support: a multicenter study by GITIL (Gruppo Italiano Terapie Innovative nei Linfomi)

Rituximab (MabThera®) for aggressive non-Hodgkin's lymphoma: systematic review and economic evaluation

Contact Info

Product

Resources

About