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Primary Mediastinal B‐cell Lymphoma, a nationwide real‐life retrospective study from Fondazione Italiana Linfomi (FIL)

2023; Wiley; Volume: 41; Issue: S2 Linguagem: Inglês

10.1002/hon.3164_300

1099-1069

Emilio Iannitto, Monica Balzarotti, Maurizio Martelli, Pier Luigi Zinzani, Alessandra Tucci, Alice Di Rocco, Federica Cavallo, Sara Veronica Usai, Anna Guidetti, Emanuele Ravano, Francesco Merli, Barbara Botto, Matteo Pelosini, Cristina Tecchio, Michele Spina, Enrico Derenzini, Silvia Finotto, Brunella Mola, Antonio Pinto, Emanuela Zanni, Roberta Battistini, Stefan Hohaus, Irene Dogliotti, Guido Gini, Vittorio Ruggero Zilioli, Sonya De Lorenzo, Anna Dodero, Alessandro Broccoli, Alessandro Maggi, Clara Mannarella, Annalisa Chiarenza, D. Pastore, Nicola Cascavilla, Pellegrino Musto, Caterina Stelitano, Francesco Di Raimondo, N. Di Renzo, Anna Marina Liberati, M. Salerno, Renato Scalone, Luca Nassi, Caterina Patti, Vita Polizzi, A. Guarini, G. Amato, Giovannino Ciccone, Andrea Evangelista, Francesco Lo Presti, Adriana Porta, Donato Mannina, Rosalba Donatella Calogero, Maurizio Musso, Ugo Consoli,

Acute Myeloid Leukemia Research

Introduction: PMBCL is an uncommon neoplasia showing unique clinicopathologic and demographic features. Front-line chemo-immunotherapy (R-CHT) plus consolidative radiotherapy (RT) allows a 5 yr OS of 80%. However, several issues still need to be debated. Methods: We designed a retrospective cohort study including 37 hematological centers throughout the national territory to describe presenting features, first-line and consolidation strategies adopted, and the outcomes in a real-world setting. All adult patients were eligible, provided they had a clinical picture coherent with that of the PMBCL, were registered in the local databases from 1/1/2007 to 31/12/2019 with a histological diagnosis of PMBCL, and were treated with an RCHT. Results: Data from 891 patients with PMBCL were retrieved. The median age was 35 yrs (IQR 28–44), and 62% were females. ECOG >2, Stage >II, LDH ratio >1, and bulky mediastinum were present in 21%, 22%, 74%, and 72% of patients, respectively. All patients received treatment with rituximab plus CHOP21 (n = 98), CHOP14 (n 181), megaCHOP (n 31), VACOPB (n 179), MACOPB (n 225), and DAEPOCH (n 179). In addition, 66 (7.5%) were consolidated with autologous stem cell transplant (ASCT), and 589 patients (66.2%) received RT. The RT consolidation rates significantly differed across therapeutic groups (p = 0.01); the lower (31%) and the higher values (90%) were reported in the R-DAEPOCH and in the R-megaCHOP groups, respectively. Final PET response assessment was available in 97% of patients, and CR was recorded in 81%. Both CR and primary failure rates were comparable across the different regimens. With a median follow-up of 5.1 years [QR: 3.5–7.6], the 5-yr PFS and OS of the entire series were 83% (95% CI: 80–85) and 91% (95% CI: 89–93), respectively. PFS curves according to different therapeutic groups and multivariate Cox proportional-hazards models are shown in Figure 1. The 5-yrs PFS and OS rates with R-MACOPB, which is the treatment of choice in Italy, were 86% (95% CI: 81–90) and 91% (95% CI: 86–94), respectively and comparable to others reported in the literature. In multivariate analysis, compared to the R-MACOPB group, R-CHOP21 treated patients showed a significantly worse PFS (HR = 2.00 95% CI: 1.08–3.72). Concerning OS, there was no substantial difference among the different R-CMTs. The IPI score (one class increase) was significantly associated with the risk of primary refractoriness, worse PFS, and OS. The presence of >1 extranodal site conferred a higher prognostic weight than the other IPI parameters. The research was funded by: Gilead Keyword: Aggressive B-cell non-Hodgkin lymphoma Conflicts of interests pertinent to the abstract. M. Balzarotti Consultant or advisory role: Roche, Takeda, Incyte, Gilead, Kiowa Kirin Honoraria: Roche, Novartis, Gilead, Eli Lilly, Incyte, Janssen Educational grants: Janssen, Beigene P. Zinzani Consultant or advisory role: Secura bio, Celltrion, Gilead, Janssen, BMS, Servier, Sandoz, MSD, Astrazeneca, Takeda, Roche, Eusapharma, Kyowa Kirin, Novartis, ADC Therap., Incyte, Beigene Honoraria: Celltrion, Gilead, Janssen, BMS, Servier, MSD, Astrazeneca, Takeda, Roche, Eusapharma, Kyowa Kirin, Novartis, Incyte, Beigene A. Di Rocco Consultant or advisory role: Roche, Takeda, Incyte, Kite-Gilead, Novartis, Honoraria: Roche Kite-Gilead Janssen Abbvie F. Cavallo Consultant or advisory role: Roche Educational grants: Takeda, Roche, Astra Zeneca, Beigene A. Guidetti Honoraria: Gilead, Novartis, Janssen, Incyte Educational grants: Roche, BMS, F. Merli Consultant or advisory role: Janssen, Gilead, MSD, Takeda, Roche, Novartis, Incyte B. Botto Consultant or advisory role: Takeda S. Finotto Educational grants: Takeda S. Hohaus Consultant or advisory role: Janssen, Gentili, Sanofi, Incyte Honoraria: Takeda, Kiowa Kyrin, MSD Educational grants: Takeda, Roche A. M. Liberati Consultant or advisory role: Takeda, Servier, Roche, Celgene, Abbvie, Incyte, Janssen, Sanofi, Verastem, Novartis, Morphosys, GSK, Oncopeptides, Karyopharm, Onconova, Archigen, Pfizer, Fibrogen Honoraria: Iquvia, Servier, Celgene, Abbvie, BMS, Janssen Educational grants: Takeda, Roche, Jansenn, Celgene, BMS, Abbvie, Novartis, Sanofi, Iqvia, Verastem L. Nassi Consultant or advisory role: Takeda, Roche, Kyowa Kirin, Incyte Honoraria: Takeda, Kyowa Kirin, Janssen, EUSApharma, Incyte Educational grants: Roche, Takeda, Janssen