What is the standard of care for primary mediastinal b‐cell lymphoma; R‐<scp>CHOP</scp> or <scp>DA</scp>‐<scp>EPOCH</scp>‐R?

Melani, Christopher; Wilson, Wyndham H.; Roschewski, Mark

doi:10.1111/bjh.15185

Cited by 4 publications

(3 citation statements)

References 10 publications

(15 reference statements)

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“…The treatment regimen largely depends on the region and choice of the investigators. Although evidence preferentially supports the use of DA-EPOCH-R because of its superior tumor control and ability to obviate the need for radiotherapy in most patients, 19 this treatment regimen often leads to higher costs, greater granulocyte-colony stimulating factor usage, longer hospitalization, and a higher number of hematological adverse events. DA-EPOCH-R also often requires a central line, which might be difficult in patients with bulky mediastinal tumors in the first treatment cycle and might increase the risk of venous thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of clinical characteristics and ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

et al. 2022

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Objective Primary mediastinal B-cell lymphoma (PMBCL) lacks standard treatment regimens. This study aimed to identify the disease’s clinical features and prognostic factors. Methods This retrospective study included 56 patients with PMBCL. Patient demographic details and clinicopathological characteristics were summarized, and their effects on progression-free survival (PFS) and overall survival (OS) were analyzed. Results The median patient age was 29 years (range, 14–56). Twenty-two patients received DA-EPOCH-R (dose-adjusted etoposide, vincristine, and doxorubicin for 96 hours with bolus doses of cyclophosphamide and oral prednisone, as well as rituximab), and 34 patients received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). Clinical/laboratory parameters, overall response rates, and 5-year PFS and OS rates did not differ between the treatment groups. Kaplan–Meier analysis indicated that late-stage disease and a higher International Prognostic Index (IPI) were associated with shorter PFS and OS. Furthermore, patients with B symptoms and first-line treatment non-responders exhibited worse OS. 18Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters, such as higher metabolic tumor volume (MTV) and total lesion glycolysis (TLG), were corrected with shorter PFS. Conclusions This study revealed that stage IV disease, higher IPI, and B symptoms were poor prognostic factors in patients with PMBCL. Significantly, higher MTV and TLG portended worse PFS.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of clinical characteristics and ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

et al. 2022

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“… 5 In adults with PMLBL, although there is a lack of consensus about the optimal therapeutic strategy for newly diagnosed patients, highly curative strategies, including rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) and dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) are mainly recommended. 6 However, significant cumulative doses of chemotherapy are achieved with both chemotherapy regimens and a substantial rate of patients still need radiation therapy (RT), especially with R-CHOP.…”

Section: Introductionmentioning

confidence: 99%

Rituximab in addition to LMB-based chemotherapy regimen in children and adolescents with primary mediastinal large B-cell lymphoma: results of the French LMB2001 prospective study

et al. 2022

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Primary Mediastinal large B-cell Lymphoma (PMLBL) is a rare entity predominantly affecting adolescents and young adults. Recently, an international phase 2 trial in pediatric patients using dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) failed to reproduce excellent survival reported in some adult studies. The optimal therapy regimen needs to be determined in this disease. French prospective LMB2001 trial included all patients < 18 years with mature B-cell lymphoma treated in French centers. For patients with PMLBL, treatment included 4 to 8 courses of Lymphomes Malins B (LMB)-based chemotherapy without radiotherapy. From 2008, rituximab was added before each chemotherapy course. From 09/2001 to 03/2012, 42 patients with PMLBL were registered. The median age was 15 years (range 8-18). 21 patients were treated by chemotherapy plus rituximab. The median follow-up was 7.1 years (Interquartile range, 5.8-11.1). Five-year event-free (EFS) and overall survival (OS) were 88.1% (95%Confidence Interval (CI), 75.0%-94.8%) and 95.2% (95%CI, 84.0%-98.7%) for the whole population. The 5-year EFS was 81.0% (95%CI, 60.0%-92.3%) and 95.2% (95%CI, 77.3%-99.2%) (HR=0.24 (95%CI 0.03-2.2)) and 5-year OS was 90.5% (95%CI, 71.1%-97.3%) and 100% for patients treated without and with rituximab, respectively. Only 1/21 patients treated with rituximab and LMB-based chemotherapy had local early treatment failure but achieved prolonged complete remission with second-line chemotherapy and radiotherapy. Intensive LMB-based chemotherapy with rituximab achieved excellent survival in children/adolescents with PMLBL. Further international prospective studies are required to confirm these results in this population.

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“…[19] Subsequently, these methods were applied to approximately evaluate seismic demands of structure. [20][21][22][23][24][25] Liao, Wen, and Foutch [26] calculated the collapse resistance of steel frame through IDA and elastic-plastic time-history analysis. The influence of different connections on seismic performance of steel frame structure is analyzed.…”

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confidence: 99%

Seismic fragility analysis of concrete encased frame‐reinforced concrete core tube hybrid structure based on quasi‐static cyclic test

Xiao

Zeng

Chen

et al. 2019

Structural Design Tall Build

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Summary Concrete‐encased frame‐core tube hybrid structural system has been widely employed in high‐rise buildings. This paper intends to analyze the seismic fragility of this structural system under ground motion excitation. The quasistatic cyclic test on a 1/5‐scaled, 10‐story three‐bay specimen is introduced. Fiber‐based finite element model is developed and integrated with numerical techniques that would be able to simulate the nonlinear response based on the OpenSees program. As the model is verified by the experimental data, a series of incremental dynamic analyses (IDAs) considering different frame‐tube stiffness ratios are carried out. IDA curves are drawn to describe each structural performance state. Fragility curves and probabilistic demand models are proposed for quantifying failure probability. The collapse margin ratio is employed to evaluate the collapse probability. The result shows that the collapse probability under rare earthquake still meets the requirement of Applied Technology Committee‐63 Report. The hybrid structure is proved to perform superior collapse resistance ability. The proper increase in the stiffness of core tube can reduce the collapse probability and enhance the collapse resistance capacity.

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What is the standard of care for primary mediastinal b‐cell lymphoma; R‐CHOP or DA‐EPOCH‐R?

Cited by 4 publications

References 10 publications

Prognostic significance of clinical characteristics and ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

Prognostic significance of clinical characteristics and ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

Rituximab in addition to LMB-based chemotherapy regimen in children and adolescents with primary mediastinal large B-cell lymphoma: results of the French LMB2001 prospective study

Seismic fragility analysis of concrete encased frame‐reinforced concrete core tube hybrid structure based on quasi‐static cyclic test

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What is the standard of care for primary mediastinal b‐cell lymphoma; R‐CHOP or DA‐EPOCH‐R?

Cited by 4 publications

References 10 publications

Prognostic significance of clinical characteristics and 18Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

Prognostic significance of clinical characteristics and 18Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

Rituximab in addition to LMB-based chemotherapy regimen in children and adolescents with primary mediastinal large B-cell lymphoma: results of the French LMB2001 prospective study

Seismic fragility analysis of concrete encased frame‐reinforced concrete core tube hybrid structure based on quasi‐static cyclic test

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Prognostic significance of clinical characteristics and ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

Prognostic significance of clinical characteristics and ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma