Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis Journal Article
| Authors: | Petrich, A. M.; Gandhi, M.; Jovanovic, B.; Castillo, J. J.; Rajguru, S.; Yang, D. T.; Shah, K. A.; Whyman, J. D.; Lansigan, F.; Hernandez-Ilizaliturri, F. J.; Lee, L. X.; Barta, S. K.; Melinamani, S.; Karmali, R.; Adeimy, C.; Smith, S.; Dalal, N.; Nabhan, C.; Peace, D.; Vose, J.; Evens, A. M.; Shah, N.; Fenske, T. S.; Zelenetz, A. D.; Landsburg, D. J.; Howlett, C.; Mato, A.; Jaglal, M.; Chavez, J. C.; Tsai, J. P.; Reddy, N.; Li, S.; Handler, C.; Flowers, C. R.; Cohen, J. B.; Blum, K. A.; Song, K.; Sun, H.; Press, O.; Cassaday, R.; Jaso, J.; Medeiros, L. J.; Sohani, A. R.; Abramson, J. S. |
| Article Title: | Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis |
| Abstract: | Patients with double-hit lymphoma (DHL), which is characterized by rearrangements of MYC and either BCL2 or BCL6, face poor prognoses. We conducted a retrospective multicenter study of the impact of baseline clinical factors, induction therapy, and stem cell transplant (SCT) on the outcomes of 311 patients with previously untreated DHL. At median follow-up of 23 months, the median progression-free survival (PFS) and overall survival (OS) rates among all patients were 10.9 and 21.9 months, respectively. Forty percent of patients remain disease-free and 49% remain alive at 2 years. Intensive induction was associated with improved PFS, but not OS, and SCT was not associated with improved OS among patients achieving first complete remission (P 5 .14). By multivariate analysis, advanced stage, central nervous system involvement, leukocytosis, and LDH >3 times the upper limit of normal were associated with higher risk of death. Correcting for these, intensive induction was associated with improved OS. We developed a novel risk score for DHL, which divides patients into high-, intermediate-, and low-risk groups. In conclusion, a subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed. |
| Keywords: | survival; adult; cancer survival; treatment response; aged; major clinical study; prednisone; clinical feature; doxorubicin; advanced cancer; cancer combination chemotherapy; cancer risk; disease free survival; cytarabine; methotrexate; rituximab; outcome assessment; follow up; disease association; carboplatin; protein bcl 2; chemoprophylaxis; progression free survival; multiple cycle treatment; etoposide; cyclophosphamide; dexamethasone; vincristine; stem cell transplantation; retrospective study; cancer therapy; ifosfamide; risk assessment; cd20 antigen; cancer regression; death; multicenter study; lymphoma; lactate dehydrogenase; protein bcl 6; high risk population; leukocytosis; induction chemotherapy; common acute lymphoblastic leukemia antigen; central nervous system disease; cancer prognosis; double hit lymphoma; consolidation chemotherapy; low risk population; human; male; female; article |
| Journal Title: | Blood |
| Volume: | 124 |
| Issue: | 15 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2014-10-09 |
| Start Page: | 2354 |
| End Page: | 2361 |
| Language: | English |
| DOI: | 10.1182/blood-2014-05-578963 |
| PROVIDER: | scopus |
| PUBMED: | 25161267 |
| DOI/URL: | |
| Notes: | Export Date: 3 November 2014 -- Source: Scopus |
