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ctt-journal > Kaplanov K.3 et al. (Abstract)

Kaplanov K.3 et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract15

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Results of early intensification in treatment of primary mediastinal diffuse large B-cell lymphoma (PMBL)

Kamil D. Kaplanov, Irina V. Matveeva, Tatiana U. Klitochenko, Ludmila S. Tregubova, Anna L. Shipaeva, Olga E. Golubeva, Olga B. Kalashnikova, Ksenia V. Demidenko, Vera A. Vasilieva

GUZ "Volgograd Regional Clinical Oncology Dispensary N1", Department of Hematology, Volgograd, Russia

Correspondence: Kamil D. Kaplanov, GUZ "Volgograd Regional Clinical Oncology Dispensary N1", Department of Hematology, Zemliachky str., 78, Volgograd, 400138, Russia, E-mail: kamilos@spam is badmail.ru

Abstract

Aim: To retrospectively analyze the results of the treatment of PMBL with the dose-intensive program CHOD-8±rituximab (R) and the application of the first-line salvage regimen EDHAP (etoposide, dexamethasone, high dose cytarabine and cis-platinum) ± rituximab (R).

Methods: The treatment of 36 patients (male 12, female 14) with PMBL was carried out from 2003 to 2009. The median patient age was 32 years. Twenty-six of 36 patients (72%) received CHOD-8-EDHAP chemotherapy. The introduction of cyclophosphamide, vincristine, and doxorubicin was performed in the CHOD-8 course on the 1st and 8th day of the cycle; the dose of doxorubicin and vincristine was similar to the CHOP program, and the dose of cyclophosphamide was 650 mg/m2. Dexamethasone was administered in doses of 10mg orally at 1–14 days of the course. The second CHOD-8 started on day 28 of therapy. The first and the second EDHAP courses were started on days 56 and 84 of treatment respectively. The rituximab addition was performed in 17 of 36 cases (47%).

Results: Five (14%) and 25 (69%) patients achieved complete and partial remission according to WHO criteria respectively. Early progression during the first line therapy was determined in two patients (6%). Resistance to the first-line therapy with minimal reduction of tumor mass happened in 4 cases (11%). In the case of partial remission chemotherapy was continued in 19 cases out of 25 (76%). Radiation therapy as an option to achieve complete remission was carried out in 6 out of 25 cases. Ten patients of 25 continued the program EDHAP±R. The 6-year survival rate is 83%.

Сonclusions: Our results confirm the high curability of PMBL by using a more intensive program than CHOP-21. However, a controlled randomized trial is needed.

Keywords: primary mediastinal lymphoma, large B-cell lymphoma, rituximab, intensification, chemotherapy