Background: The addition of rituximab to anthracycline-containing chemotherapy has significantly improved outcome in patients (pts) with diffuse large B-cell lymphomas. The impact of this monoclonal antibody in IVL, a rare variant of diffuse large B-cell lymphoma characterised by the growth of neoplastic cells into small blood vessels was recently explored in a large series of Japanese pts, while experience in IVL pts diagnosed in Western Countries is limited to a few case reports Methods: The impact of the addition of rituximab was evaluated in 28 pts affected by CD20+ IVL eligible for CHOP/CHOP-like regimen: 8 pts were treated with rituximab +chemotherapy (R-CT) and 20 with chemotherapy alone (CT). Results: Median age was 67 yrs (range 39-86; 15 males). 75% of pts had an IPI‡3. B symptoms, PS‡3, increased LDH levels, and stage IV were respectively observed in 78%, 41%, 88%, and 71% of cases. Skin (44%), CNS (30%) and bone marrow (30%) were the most common sites. Laboratory tests revealed: anemia (78%), leucopenia (30%), thrombocytopenia (37%), and increased LDH (88%). No significant differences between R-CT and CT groups were observed. Overall, 18 (64%) pts achieved complete remission (CR), and 2 partial response with an early progression (PD), 6 (21%) experienced a PD, and 2, both in CT group, died of toxicity. Noteworthy CR was obtained in 100% of R-CT versus 50% of CT pts (p=0.03); the addition of rituximab was related to CRR. At a median f-up of 14 mo, all 8 R-CT pts are alive and relapse free; at a median f-up of 71 mo, only 7 CT pts are alive and disease-free. The 3-yr EFS was 35% in CT group and 100% for R-CT pts (p<0.0001); the 3-yr OS was 39% and 100%, respectively (p<0.0001). Conclusions: the addition of rituximab to anthracycline-based chemotherapy significantly improves outcome in IVL pts diagnosed in Western Countries. A confirmatory international prospective trials is warranted. On behalf of the International Extranodal Lymphoma Study Group (IELSG)
Rituximab improves outcome in Western patients with intravascular large B-cell lymphoma (IVL) / G. P., Dognini; M., Ponzoni; O., Bairey; C., Montalban; A., Szomor; L., Uziel; J., Seymour; A., Ambrosetti; Martelli, Maurizio; G., Rossi; M., Federico; A., Candoni; A., De Renzo; M., Piris; E., Zucca; C., Doglioni; A. J., Ferreri. - In: ANNALS OF ONCOLOGY. - ISSN 0923-7534. - 19 (SUPPL. 4):(2008), pp. 190-190. (Intervento presentato al convegno 10th International Conference on Malignant Lymphoma tenutosi a Lugano, SWITZERLAND nel JUN 04-07, 2008) [10.1093/annonc/mdn246].
Rituximab improves outcome in Western patients with intravascular large B-cell lymphoma (IVL)
MARTELLI, Maurizio;
2008
Abstract
Background: The addition of rituximab to anthracycline-containing chemotherapy has significantly improved outcome in patients (pts) with diffuse large B-cell lymphomas. The impact of this monoclonal antibody in IVL, a rare variant of diffuse large B-cell lymphoma characterised by the growth of neoplastic cells into small blood vessels was recently explored in a large series of Japanese pts, while experience in IVL pts diagnosed in Western Countries is limited to a few case reports Methods: The impact of the addition of rituximab was evaluated in 28 pts affected by CD20+ IVL eligible for CHOP/CHOP-like regimen: 8 pts were treated with rituximab +chemotherapy (R-CT) and 20 with chemotherapy alone (CT). Results: Median age was 67 yrs (range 39-86; 15 males). 75% of pts had an IPI‡3. B symptoms, PS‡3, increased LDH levels, and stage IV were respectively observed in 78%, 41%, 88%, and 71% of cases. Skin (44%), CNS (30%) and bone marrow (30%) were the most common sites. Laboratory tests revealed: anemia (78%), leucopenia (30%), thrombocytopenia (37%), and increased LDH (88%). No significant differences between R-CT and CT groups were observed. Overall, 18 (64%) pts achieved complete remission (CR), and 2 partial response with an early progression (PD), 6 (21%) experienced a PD, and 2, both in CT group, died of toxicity. Noteworthy CR was obtained in 100% of R-CT versus 50% of CT pts (p=0.03); the addition of rituximab was related to CRR. At a median f-up of 14 mo, all 8 R-CT pts are alive and relapse free; at a median f-up of 71 mo, only 7 CT pts are alive and disease-free. The 3-yr EFS was 35% in CT group and 100% for R-CT pts (p<0.0001); the 3-yr OS was 39% and 100%, respectively (p<0.0001). Conclusions: the addition of rituximab to anthracycline-based chemotherapy significantly improves outcome in IVL pts diagnosed in Western Countries. A confirmatory international prospective trials is warranted. On behalf of the International Extranodal Lymphoma Study Group (IELSG)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
