ISSN (print) 1997-6933     ISSN (online) 2500-2139
Vol. 17 No. 4 (2024), CLINICAL TRIALS
Vol. 17 No. 4 (2024)
CLINICAL TRIALS

Response-Adapted Strategy in the Treatment of Primary Mediastinal Large B-Cell Lymphoma: Results of a Prospective Single-Center Clinical Trial

Published 01.10.2024
Yana Konstantinovna Mangasarova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0003-1936-5934
R.R. Abdurashidova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-5148-8355
A.U. Magomedova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0003-4263-8275
O.V. Margolin
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-6211-5677
E.S. Nesterova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0001-8467-2514
L.G. Gorenkova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-3967-9183
M.O. Bagova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-8932-8197
E.A. Fastova
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-2822-0844
D.S. Belkina
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0009-0008-7787-6250
A.M. Kovrigina
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-1082-8659
N.G. Gabeeva
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0001-5171-0414
D.A. Koroleva
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0001-5762-8294
S.K. Kravchenko
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-7721-2074
Yu.A. Chabaeva
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0001-8044-598X
E.E. Zvonkov
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-2639-7419
2024-4
PDF_2024-17-4_335-346 (Russian)

Keywords

primary mediastinal (thymic) large B-cell lymphoma
DA-EPOCH-R
high-dose chemotherapy
auto-HSCT
immune checkpoint inhibitors
response-adapted strategy of therapy
pregnancy

How to Cite

Mangasarova Y.K., Abdurashidova R.R., Magomedova A.U., Margolin O.V., Nesterova E.S., Gorenkova L.G., Bagova M.O., Fastova E.A., Belkina D.S., Kovrigina A.M., Gabeeva N.G., Koroleva D.A., Kravchenko S.K., Chabaeva Y.A., Zvonkov E.E. Response-Adapted Strategy in the Treatment of Primary Mediastinal Large B-Cell Lymphoma: Results of a Prospective Single-Center Clinical Trial. Clinical Oncohematology. 2024;(4):335–346. doi:10.21320/2500-2139-2024-17-4-335-346.
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver AMA ГОСТ

Download Citation

Endnote/Zotero/Mendeley (RIS) BibTeX

Keywords

Abstract

BACKGROUND. Up to now, neither the optimal treatment regimen for primary mediastinal large B-cell lymphoma (PMBCL), nor poor/favorable prognostic factors for risk stratification at the disease onset have been found. The prognosis of PMBCL is determined by the depth of metabolic response by the time of treatment completion, which underlies a response-adapted strategy. Besides, PMBCL is an aggressive tumor occurring more commonly in young women of reproductive age, which requires the development of treatment strategy during pregnancy.

AIM. To assess the efficacy of the response-adapted strategy in PMBCL treatment based on the DA-EPOCH-R program in remission induction with drug dose escalation and without subsequent radiotherapy, if a complete metabolic response is reported by PET-CT.

MATERIALS & METHODS. This prospective single-center clinical trial enrolled 154 patients in the period from November 2012 to March 2023. The median age of the patients was 34 years (range 19–68 years). There were 51 (33.1 %) men and 103 (66.9 %) women, 11 of whom were at various gestational ages of pregnancy.

RESULTS. The response-adapted treatment was completed in all 154 patients. Overall response was 93.5 % (144/154), complete remission was 78.6 % (121/154), and partial remission was 14.9 % (23/154). Progression was reported in 6.5 % (10/154) of patients. With a follow-up of 60 months, the overall, disease-free, progression-free, and event-free survival rates were 93 %, 98 %, 92 %, and 76 %, respectively. The median was not reached. Prior to chemotherapy, 11 pregnant women aged 21–37 (median 29 years) had been assessed. By the time of PMBCL diagnosis, the gestational age of them varied from 9 to 37 weeks (median 26 weeks). Immunochemotherapy was administered to 9 women during pregnancy. At the gestational age of 27–38 weeks (median 34 weeks) delivery was reported in 10 patients who gave birth to 11 children. The children showed no malformations. All women with PMBCL diagnosed during pregnancy and all their children had been followed-up by the time of this publication.

CONCLUSION. The response-adapted strategy of PMBCL treatment with the DA-EPOCH-R regimen and drug dose escalation showed a high immediate and long-term efficacy as well as tolerable toxicity, which provided ground for the decision against radiotherapy, if a complete metabolic response was reported by PET-CT. The results of this trial establish the main goal of treating aggressive lymphomas during pregnancy which is saving of two lives. Delivery of newborns without malformations despite immunochemotherapy justifies the use of the DA-EPOCH-R program at the gestational age > 12 weeks.

PDF_2024-17-4_335-346 (Russian)

References

  1. Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization Classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia. 2022;36(7):1720–48. doi: 10.1038/s41375-022-01620-2.
  2. Campo E, Jaffe ES, Cook JR, et al. The International Consensus Classification of mature lymphoid neoplasms: a report from the Clinical Advisory Committee. Blood. 2022;140(11):1229–53. doi: 10.1182/blood.2022015851.
  3. Cazals-Hatem D, Lepage E, Brice P, et al. Primary mediastinal large B-cell lymphoma. A clinicopathologic study of 141 cases compared with 916 nonmediastinal large B-cell lymphomas, a GELA (“Groupe d’Etude des Lymphomes de l’Adulte”) study. Am J Surg Pathol. 1996;20(7):877–88. doi: 10.1097/00000478-199607000-00012.
  4. Zhou H, Liu Q, Lu S, et al. Primary mediastinal/thymic diffuse large B-cell lymphoma: a population-based study on incidence and survival. Ann Hematol. 2023;102(7):1879–86. doi: 10.1007/s00277-023-05225-2.
  5. Мангасарова Я.К., Магомедова А.У., Нестерова Е.С. и др. Терапия агрессивных неходжкинских лимфом у беременных Клиническая онкогематология. 2020;13(3):316–21. doi: 10.21320/2500-2139-2020-13-3-316-321. [Mangasarova Ya.K., Magomedova A.U., Nesterova E.S., et al. Treatment of Aggressive Non-Hodgkin’s Lymphomas in Pregnancy. Clinical oncohematology. 2020;13(3):316–21. doi: 10.21320/2500-2139-2020-13-3-316-321. (In Russ)]
  6. Шмаков Р.Г., Ахмедова А.И., Полушкина Е.С. и др. Современные принципы ведения беременности у пациенток с лимфомам. Акушерство и гинекология. 2019;7:40–8. doi: 10.18565/aig.2019.7.40-48. [Shmakov R.G., Akhmedova A.I., Polushkina E.S., et al. Modern principles of pregnancy management in patients with lymphomas. Obstetrics and Gynecology. 2019;7:40–8. doi: 10.18565/aig.2019.7.40-48. (In Russ)]
  7. Zinzani PL, Martelli M, Bertini M, et al. Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients. Haematologica. 2002;87(12):1258–64.
  8. Мангасарова Я.К., Магомедова А.У., Ковригина А.М. и др. Первичная медиастинальная (тимическая) В-крупноклеточная лимфома: диагностика отдаленных экстрамедиастинальных поражений и возможности лечения. Клиническая онкогематология. 2018;11(3):220–6. doi: 10.21320/2500-2139-2018-11-3-220-226. [Mangasarova Ya.K., Magomedova A.U., Kovrigina A.M., et al. Primary Mediastinal (Thymic) Large B-Cell Lymphoma: Diagnostics of Extramediastinal Lesions and Treatment Opportunities. Clinical oncohematology. 2018;11(3):220–6. doi: 10.21320/2500-2139-2018-11-3-220-226. (In Russ)]
  9. Giulino-Roth L, O’Donohue T, Chen Z, et al. Outcomes of adults and children with primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-R. Br J Haematol. 2017;179(5):739–47. doi: 10.1111/bjh.14951.
  10. Магомедова А.У., Фастова Е.А., Ковригина А.М. и др. Поражение костного мозга при первичной медиастинальной В-крупноклеточной лимфоме. Терапевтический архив. 2017;89(7):65–8. doi: 10.17116/terarkh201789765-68. [Magomedova A.U., Fastova E.A., Kovrigina A.M., et al. Bone marrow involvement in primary mediastinal B-cell lymphoma. Terapevticheskii arkhiv. 2017;89(7):65–8. doi: 10.17116/terarkh201789765-68. (In Russ)]
  11. Steidl C, Gascoyne RD. The molecular pathogenesis of primary mediastinal large B-cell lymphoma. Blood. 2011;118(10):2659–69. doi: 10.1182/blood-2011-05-326538.
  12. Masternak K, Muhlethaler-Mottet A, Villard J, et al. CIITA is a transcriptional coactivator that is recruited to MHC class II promoters by multiple synergistic interactions with an enhanceosome complex. Genes Dev. 2000;14(9):1156–66. doi: 10.1101/gad.14.9.1156.
  13. Mottok A, Wright G, Rosenwald A, et al. Molecular classification of primary mediastinal large B-cell lymphoma using routinely available tissue specimens. Blood. 2018;132(22):2401–5. doi: 10.1182/blood-2018-05-851154.
  14. Scholl T, Mahanta SK, Strominger JL. Specific complex formation between the type II bare lymphocyte syndrome-associated transactivators CIITA and RFX5. Proc Natl Acad Sci USA. 1997;94(12):6330–4. doi: 10.1073/pnas.94.12.6330.
  15. Savage KJ, Monti S, Kutok JL, et al. The molecular signature of mediastinal large B-cell lymphoma differs from that of other diffuse large B-cell lymphomas and shares features with classical Hodgkin lymphoma. Blood. 2003;102(12):3871–9. doi: 10.1182/blood-2003-06-1841.
  16. Risinskaya N, Mangasarova Y, Nikulina E, et al. STR Profiling Reveals Tumor Genome Instability in Primary Mediastinal B-Cell Lymphoma. Curr Oncol. 2022;29(5):3449–59. doi: 10.3390/curroncol29050278.
  17. Мангасарова Я.К., Мисюрин А.В., Магомедова А.У. и др. Молекулярная диагностика первичной медиастинальной В-клеточной лимфомы и диффузной В-крупноклеточной лимфомы с первичным вовлечением лимфоузлов средостения. Клиническая онкогематология. 2011;4(2):142–5. [Mangasarova Ya.K., Misyurin A.V., Magomedova A.U., et al. Molecular diagnosis of primary mediastinal B-cell lymphoma and diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes. Klinicheskaya onkogematologiya. 2011;4(2):142–5. (In Russ)]
  18. Кузнецова С.А., Обухова Т.Н., Сурин В.Л. и др. Характеристика цитогенетических и молекулярно-генетических нарушений CIITA у больных с первичной медиастинальной крупноклеточной В-клеточной лимфомой. Гематология и трансфузиология. 2020;65(1):158–9. [Kuznetsova S.A., Obukhova T.N., Surin V.L., et al. Cytogenetic and molecular genetic abnormalities of CIITA in patients with primary mediastinal large B-cell lymphoma. Gematologiya i transfuziologiya. 2020;65(1):158–9. (In Russ)]
  19. Lisenko K, Dingeldein G, Cremer M, et al. Addition of rituximab to CHOP-like chemotherapy in first line treatment of primary mediastinal B-cell lymphoma. BMC Cancer. 2017;17(1):359. doi: 10.1186/s12885-017-3332-3.
  20. Vassilakopoulos TP, Pangalis GA, Katsigiannis A, et al. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone with or without radiotherapy in primary mediastinal large B-cell lymphoma: the emerging standard of care. Oncologist. 2012;17(2):239–49. doi: 10.1634/theoncologist.2011-0275.
  21. Rieger M, Osterborg A, Pettengell R, et al. Primary mediastinal B-cell lymphoma treated with CHOP-like chemotherapy with or without rituximab: results of the Mabthera International Trial Group study. Ann Oncol. 2011;22(3):664–70. doi: 10.1093/annonc/mdq418.
  22. Xu LM, Fang H, Wang WH, et al. Prognostic significance of rituximab and radiotherapy for patients with primary mediastinal large B-cell lymphoma receiving doxorubicin-containing chemotherapy. Leuk Lymphoma. 2013;54(8):1684–90. doi: 10.3109/10428194.2012.746684.
  23. Тумян Г.С., Заводнова И.З., Кичигина М.Ю., Медведовская Е.Г. Первичная медиастинальная (тимическая) В-крупноклеточная лимфома. Клиническая онкогематология. 2017;10(1):13–24. doi: 10.21320/2500-2139-2017-10-1-13-24. [Tumyan G.S., Zavodnova I.Z., Kichigina M.Yu., Medvedovskaya E.G. Primary Mediastinal (Thymic) Large B-Cell Lymphoma. Clinical oncohematology. 2017;10(1):13–24. doi: 10.21320/2500-2139-2017-10-1-13-24. (In Russ)]
  24. Avigdor A, Sirotkin T, Kedmi M, et al. The impact of R-VACOP-B and interim FDG-PET/CT on outcome in primary mediastinal large B cell lymphoma. Ann Hematol. 2014;93(8):1297–304. doi: 10.1007/s00277-014-2043-y.
  25. Zinzani PL, Stefoni V, Finolezzi E, et al. Rituximab combined with MACOP-B or VACOP-B and radiation therapy in primary mediastinal large B-cell lymphoma: a retrospective study. Clin Lymphoma Myeloma. 2009;9(5):381–5. doi: 10.3816/CLM.2009.n.074.
  26. Wilson WH, Grossbard ML, Pittaluga S, et al. Dose-adjusted EPOCH chemotherapy for untreated large B-cell lymphomas: a pharmacodynamic approach with high efficacy. Blood. 2002;99(8):2685–93. doi: 10.1182/blood.v99.8.2685.
  27. Dunleavy K, Pittaluga S, Maeda LS, et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013;368(15):1408–16. doi: 10.1056/NEJMoa1214561.
  28. Shah NN, Szabo A, Huntington SF, et al. R-CHOP versus dose-adjusted R-EPOCH in frontline management of primary mediastinal B-cell lymphoma: a multi-centre analysis. Br J Haematol. 2018;180(4):534–44. doi: 10.1111/bjh.15051.
  29. Malenda A, Kolkowska-Lesniak A, Pula B, et al. Outcomes of treatment with dose-adjusted EPOCH-R or R-CHOP in primary mediastinal large B-cell lymphoma. Eur J Haematol. 2020;104(1):59–66. doi: 10.1111/ejh.13337.
  30. Martelli M, Ceriani L, Zucca E, et al. [18F]fluorodeoxyglucose positron emission tomography predicts survival after chemoimmunotherapy for primary mediastinal large B-cell lymphoma: results of the International Extranodal Lymphoma Study Group IELSG-26 Study. J Clin Oncol. 2014;32(17):1769–75. doi: 10.1200/JCO.2013.51.7524.
  31. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059–68. doi: 10.1200/JCO.2013.54.8800.
  32. Amit O, Barzilai M, Avivi I. Management of Hematologic Malignancies: Special Considerations in Pregnant Women. Drugs. 2015;75(15):1725–38. doi: 10.1007/s40265-015-0464-0.
  33. Perez CA, Amin J, Aguina LM, et al. Primary Mediastinal Large B-Cell Lymphoma during Pregnancy. Case Rep Hematol. 2012;2012:197347. doi: 10.1155/2012/197347.
  34. Lee EJ, Ahn KH, Hong SC, et al. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy for diffuse large B-cell lymphoma in pregnancy may be associated with preterm birth. Obstet Gynecol Sci. 2014;57(6):526–9. doi: 10.5468/ogs.2014.57.6.526.
  35. Decker M, Rothermundt C, Hollander G, et al. Rituximab plus CHOP for treatment of diffuse large B-cell lymphoma during second trimester of pregnancy. Lancet Oncol. 2006;7(8):693–4. doi: 10.1016/S1470-2045(06)70797-5.
  36. Fiascone S, Datkhaeva I, Winer ES, Rizack T. Primary mediastinal large B-cell lymphoma in pregnancy. Leuk Lymphoma. 2016;57(1):240–3. doi: 10.3109/10428194.2015.1049168.
  37. Evens AM, Advani R, Lossos IS, et al. Lymphoma in pregnancy: excellent fetal outcomes and maternal survival in a large multicenter analysis. Blood. 2011;118(21):94. doi: 1182/blood.v118.21.94.94.
  38. Camus V, Rossi C, Sesques P, et al. Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma: a LYSA study. Blood Adv. 2021;5(19):3862–72. doi: 10.1182/bloodadvances.2021004778.
  39. Ceriani L, Martelli M, Conconi A, et al. Prognostic models for primary mediastinal (thymic) B-cell lymphoma derived from 18-FDG PET/CT quantitative parameters in the International Extranodal Lymphoma Study Group (IELSG) 26 study. Br J Haematol. 2017;178(4):588–91. doi: 10.1111/bjh.14728.
  40. Vassilakopoulos TP, Papageorgiou SG, Angelopoulou MK, et al. Positron emission tomography after response to rituximab-CHOP in primary mediastinal large B-cell lymphoma: impact on outcomes and radiotherapy strategies. Ann Hematol. 2021;100(9):2279–92. doi: 10.1007/s00277-021-04421-2.
  41. De Mello CA, De Andrade VP, De Lima VC, et al. Prognostic impact of MUM1 expression by immunohistochemistry on primary mediastinal large B-cell lymphoma. Leuk Lymphoma. 2011;52(8):1495–503. doi: 10.3109/10428194.2011.573032.
  42. Мангасарова Я.К., Магомедова А.У., Нестерова Е.С. и др. Первые результаты терапии первичной медиастинальной В-крупноклеточной лимфомы по программе R-DA-EPOCH-21. Терапевтический архив. 2016;88(7):37–42. doi: 10.17116/terarkh201688737-42. [Mangasarova Ya.K., Magomedova A.U., Nesterova E.S., et al. Therapy for primary mediastinal large B-cell lymphoma in accordance with the R-DA-EPOCH-21 program: The first results. Terapevticheskii arkhiv. 2016;88(7):37–42. doi: 10.17116/terarkh201688737-42. (In Russ)]
  43. Габеева Н.Г., Королева Д.А., Татарникова С.А. и др. Промежуточные результаты терапии первичной медиастинальной В-крупноклеточной лимфомы по протоколам «ПМЛ-16» и «ПМЛ-19». Гематология и трансфузиология. 2022;67(3):328–50. doi: 10.35754/0234-5730-2022-67-3-328-350. [Gabeeva N.G., Koroleva D.A., Tatarnikova S.A., et al. Interim results of the PML-16, PML-19 protocols for primary mediastinal large B-cell lymphoma therapy. Russian journal of hematology and transfusiology. 2022;67(3):328–50. doi: 10.35754/0234-5730-2022-67-3-328-350. (In Russ)]
  44. Melani C, Advani R, Roschewski M, et al. End-of-treatment and serial PET imaging in primary mediastinal B-cell lymphoma following dose-adjusted EPOCH-R: a paradigm shift in clinical decision making. Haematologica. 2018;103(8):1337–44. doi: 10.3324/haematol.2018.192492.
  45. Rivas-Delgado A, Nadeu F, Andrade-Campos M, et al. Cell-Free DNA for Genomic Analysis in Primary Mediastinal Large B-Cell Lymphoma. Diagnostics (Basel). 2022;12(7):1575. doi: 10.3390/diagnostics12071575.
  46. Kurtz DM, Scherer F, Jin MC, et al. Circulating Tumor DNA Measurements As Early Outcome Predictors in Diffuse Large B-Cell Lymphoma. J Clin Oncol. 2018;36(28):2845–53. doi: 10.1200/JCO.2018.78.5246.
  47. Dourthe ME, Phulpin A, Auperin A, et al. Rituximab in addition to LMB-based chemotherapy regimen in children and adolescents with primary mediastinal large B-cell lymphoma: results of the French LMB2001 prospective study. Haematologica. 2022;107(9):2173–82. doi: 10.3324/haematol.2021.280257.
  48. Seidemann K, Tiemann M, Lauterbach I, et al. Primary mediastinal large B-cell lymphoma with sclerosis in pediatric and adolescent patients: treatment and results from three therapeutic studies of the Berlin-Frankfurt-Munster Group. J Clin Oncol. 2003;21(9):1782–9. doi: 10.1200/JCO.2003.08.151.
  49. Gerrard M, Waxman IM, Sposto R, et al. Outcome and pathologic classification of children and adolescents with mediastinal large B-cell lymphoma treated with FAB/LMB96 mature B-NHL therapy. Blood. 2013;121(2):278–85. doi: 10.1182/blood-2012-04-422709.
  50. Knorr F, Zimmermann M, Attarbaschi A, et al. Dose-adjusted EPOCH-rituximab or intensified B-NHL therapy for pediatric primary mediastinal large B-cell lymphoma. Haematologica. 2021;106(12):3232–5. doi: 10.3324/haematol.2021.278971.
  51. Hoelzer D, Hiddemann W, Baumann A, et al. High Survival Rate in Adult Burkitt’s Lymphoma/Leukemia and Diffuse Large B-Cell Lymphoma with Mediastinal Involvement. Blood. 2007;110(211):518. doi: 10.1182/blood.v110.11.518.518.
  52. Мангасарова Я.К., Магомедова А.У., Кравченко С.К. и др. Восьмилетний опыт лечения агрессивных В-крупноклеточных лимфом средостения. Терапевтический архив. 2013;85(7):50–6. [Mangasarova Ya.K., Magomedova A.U., Kravchenko S.K., et al. Eight-year experience in treating aggressive mediastinal large B-cell lymphomas. Terapevticheskii arkhiv. 2013;85(7):50–6. (In Russ)]
  53. Romejko-Jarosinska J, Ostrowska B, Dabrowska-Iwanicka A, et al. High efficacy of intensive immunochemotherapy for primary mediastinal B-cell lymphoma with prolonged follow up. Sci Rep. 2022;12(1):10551. doi: 10.1038/s41598-022-14067-3.
  54. Cwynarski K, Marzolini MAV, Barrington SF, et al. The management of primary mediastinal B-cell lymphoma: a British Society for Haematology Good Practice Paper. Br J Haematol. 2019;185(3):402–9. doi: 10.1111/bjh.15731.
  55. Goldschmidt N, Kleinstern G, Orevi M, et al. Favorable outcome of primary mediastinal large B-cell lymphoma patients treated with sequential RCHOP-RICE regimen without radiotherapy. Cancer Chemother Pharmacol. 2016;77(5):1053–60. doi: 10.1007/s00280-016-3024-8.
  56. Messmer M, Tsai HL, Varadhan R, et al. R-CHOP without radiation in frontline management of primary mediastinal B-cell lymphoma. Leuk Lymphoma. 2019;60(5):1261–5. doi: 10.1080/10428194.2018.1519812.
  57. Camus V, Rossi C, Sesques P, et al. Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma: a LYSA study. Blood Adv. 2021;5(19):3862–72. doi: 10.1182/bloodadvances.2021004778.
  58. Hayden AR, Tonseth P, Lee DG, et al. Outcome of primary mediastinal large B-cell lymphoma using R-CHOP: impact of a PET-adapted approach. Blood. 2020;136(24):2803–11. doi: 10.1182/blood.2019004296.
  59. Pinnix CC, Dabaja B, Ahmed MA, et al. Single-institution experience in the treatment of primary mediastinal B cell lymphoma treated with immunochemotherapy in the setting of response assessment by 18fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys. 2015;92(1):113–21. doi: 10.1016/j.ijrobp.2015.02.006.
  60. Tai WM, Quah D, Yap SP, et al. Primary mediastinal large B-cell lymphoma: optimal therapy and prognostic factors in 41 consecutive Asian patients. Leuk Lymphoma. 2011;52(4):604–12. doi: 10.3109/10428194.2010.550073.
  61. Zucca E, Davies A, Kryachok I, et al. Observation vs. radiotherapy in primary mediastinal B-cell lymphoma patients with complete response to standard immunochemotherapy: The IELSG37 randomized trial. J Clin Oncol. 2023;41(17_suppl):LBA7505. doi: 10.1200/JCO.2023.41.17_suppl.LBA7505.
  62. Vassilakopoulos TP, Panitsas F, Mellios Z, et al. Incidence and risk factors for central nervous system relapse in patients with primary mediastinal large B-cell lymphoma in the rituximab era. Hematol Oncol. 2023;41(1):97–107. doi: 10.1002/hon.3096.
  63. Ferreri AJ, Bruno-Ventre M, Donadoni G, et al. Risk-tailored CNS prophylaxis in a mono-institutional series of 200 patients with diffuse large B-cell lymphoma treated in the rituximab era. Br J Haematol. 2015;168(5):654–62. doi: 10.1111/bjh.13194.
  64. Cheah CY, Herbert KE, O’Rourke K, et al. A multicentre retrospective comparison of central nervous system prophylaxis strategies among patients with high-risk diffuse large B-cell lymphoma. Br J Cancer. 2014;111(6):1072–9. doi: 10.1038/bjc.2014.405.
  65. Bobillo S, Joffe E, Sermer D, et al. Prophylaxis with intrathecal or high-dose methotrexate in diffuse large B-cell lymphoma and high risk of CNS relapse. Blood Cancer J. 2021;11(6):113. doi: 10.1038/s41408-021-00506-3.
  66. Lees C, Keane C, Gandhi MK, Gunawardana J. Biology and therapy of primary mediastinal B-cell lymphoma: current status and future directions. Br J Haematol. 2019;185(1):25–41. doi: 10.1111/bjh.15778.
  67. Magomedova A, Kravchenko S, Misyurina A, et al. P1207: Multicenter randomized controlled (comparative) open prospective study to evaluate the efficacy of the R-DA-EPOCH-21 and R-MNHL-BFM-90 ± auto-HSCT programs in patients with de novo diffuse B-cell lar. Hemasphere. 2022;6(Suppl):1093–4. doi: 10.1097/01.HS9.0000847692.97408.4c.
  68. Wilson MR, Eyre TA, Kirkwood AA, et al. Timing of high-dose methotrexate CNS prophylaxis in DLBCL: a multicenter international analysis of 1384 patients. Blood. 2022;139(16):2499–511. doi: 10.1182/blood.2021014506.
  69. Orellana-Noia VM, Reed DR, McCook AA, et al. Single-route CNS prophylaxis for aggressive non-Hodgkin lymphomas: real-world outcomes from 21 US academic institutions. Blood. 2022;139(3):413–23. doi: 10.1182/blood.2021012888.
  70. Thieblemont C, Altmann B, Frontzek F, et al. Central nervous system relapse in younger patients with diffuse large B-cell lymphoma: a LYSA and GLA/DSHNHL analysis. Blood Adv. 2023;7(15):3968–77. doi: 10.1182/bloodadvances.2022008888.
  71. Puckrin R, El Darsa H, Ghosh S, et al. Ineffectiveness of high-dose methotrexate for prevention of CNS relapse in diffuse large B-cell lymphoma. Am J Hematol. 2021;96(7):764–71. doi: 10.1002/ajh.26181.
  72. Королева Д.А., Габеева Н.Г., Галстян Г.М. и др. Успешное лечение рецидивов первичной медиастинальной В-крупноклеточной лимфомы с поражением центральной нервной системы. Гематология и трансфузиология. 2023;68(3):398–409. doi: 10.35754/0234-5730-2023-68-3-398-409. [Koroleva D.A., Gabeeva N.G., Galstyan G.M., et al. Successful treatment of relapses of primary mediastinal large B-cell lymphoma with central nervous system involvement. Russian journal of hematology and transfusiology. 2023;68(3):398–409. doi: 10.35754/0234-5730-2023-68-3-398-409. (In Russ)]
  73. Tilly H, Morschhauser F, Sehn LH, et al. Polatuzumab Vedotin in Previously Untreated Diffuse Large B-Cell Lymphoma. N Engl J Med. 2022;386(4):351–63. doi: 10.1056/NEJMoa2115304.
  74. Younes A, Sehn LH, Johnson P, et al. Randomized Phase III Trial of Ibrutinib and Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Non-Germinal Center B-Cell Diffuse Large B-Cell Lymphoma. J Clin Oncol. 2019;37(15):1285–95. doi: 10.1200/JCO.18.02403.
  75. Wirsching HG, Weller M, Balabanov S, Roth P. Targeted Therapies and Immune Checkpoint Inhibitors in Primary CNS Lymphoma. Cancers (Basel). 2021;13(12):3073. doi: 10.3390/cancers13123073.
  76. Zinzani PL, Thieblemont C, Melnichenko V, et al. Pembrolizumab in relapsed or refractory primary mediastinal large B-cell lymphoma: final analysis of KEYNOTE-170. Blood. 2023;142(2):141–5. doi: 10.1182/blood.2022019340.
  77. Terziev D, Hutter B, Klink B, et al. Nivolumab maintenance after salvage autologous stem cell transplantation results in long-term remission in multiple relapsed primary CNS lymphoma. Eur J Haematol. 2018;101(1):115–8. doi: 10.1111/ejh.13072.
  78. Smirnova S, Nikulina E, Gabeeva N, et al. Circulating free DNA analysis in Russian with primary mediastinal lymphoma EHA-2305 (poster). HemaSphere. 2020;4(S1):1024–5.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Copyright (c) 2024 Clinical Oncohematology