TY - JOUR
T1 - Diffuse large B-cell lymphoma with primary treatment failure
T2 - Ultra-high risk features and benchmarking for experimental therapies
AU - Costa, Luciano J.
AU - Maddocks, Kami
AU - Epperla, Narendranath
AU - Reddy, Nishitha M.
AU - Karmali, Reem
AU - Umyarova, Elvira
AU - Bachanova, Veronika
AU - Costa, Cristiana
AU - Glenn, Martha J.
AU - Chavez, Julio C.
AU - Calzada, Oscar
AU - Lansigan, Frederick
AU - Nasheed, Hossain
AU - Barta, Stefan K.
AU - Zhou, Zheng
AU - Jaglal, Michael
AU - Chhabra, Saurabh
AU - Hernandez-Ilizaliturri, Francisco
AU - Xavier, Ana C.
AU - Mehta, Amitkumar
AU - Peker, Deniz
AU - Forero-Torres, Andreas
AU - Al-Mansour, Zeina
AU - Evens, Andrew M.
AU - Cohen, Jonathon B.
AU - Flowers, Christopher R.
AU - Fenske, Timothy S.
AU - Hamadani, Mehdi
N1 - Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2–3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.
AB - The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2–3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.
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U2 - 10.1002/ajh.24615
DO - 10.1002/ajh.24615
M3 - Article
C2 - 27880984
AN - SCOPUS:85009832242
SN - 0361-8609
VL - 92
SP - 161
EP - 170
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 2
ER -