Yazarlar : Wilson W, Jung SH, Porcu P, Hurd D, Johnson J, Martin SE, Czuczman M, Lai R, Said J, Chadburn A, Jones D, Dunleavy K, Canellos G, Zelenetz A, Cheson B, Hsi E.

Yayın : Haematologica.

Yayın Yılı : 2011

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22133772

Konu : Lenfoma

Literatür İçeriği :  

Abstract

Background: A phase II trial of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab (DA-EPOCH-R) from the National Cancer Institute showed promising activity in untreated diffuse large B-cell lymphoma. The Cancer and Leukemia Group B conducted a study to determine if these results could be reproduced in a multi-institutional setting. Design and Methods: This is a phase II study of 69 patients with untreated diffuse large B-cell lymphoma of at least 18 years of age and at least stage II. Radiation was not permitted. Patients had a median age of 58 (range: 23-83) years and 40% had high-intermediate or high International Prognostic Index risk. Immunohistochemical biomarkers for cell or origin and proliferation were performed. Results: With a median follow-up of 62 months, time to progression and overall survival were 81% and 84%, respectively, and time to progression was 87%, 92% and 54% for low/low-intermediate, high-intermediate and high international prognostic index risk groups, respectively, at five-years and beyond. The time to progression and event-free survival of germinal center B-cell were 100% and 94%, respectively, and non-germinal center B-cell GCB diffuse large B-cell lymphoma were 67% and 58%, respectively, at 62 months (germinal center versus non-germinal center B-cell p=0.008). DA-EPOCH-R was tolerated without significant grade 4 non-hematological toxicities. Conclusions: These results provide the first confirmation by a multi-institutional group that DA-EPOCH-R provides high durable remissions in diffuse large B-cell lymphoma and is effective in both germinal center and non-germinal center B-cell subtypes. The trial was registered at ClinicalTrials.Gov (NCT00032019)

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