Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis

Adam M. Petrich*, Mitul Gandhi, Borko Jovanovic, Jorge J. Castillo, Saurabh Rajguru, David T. Yang, Khushboo A. Shah, Jeremy D. Whyman, Frederick Lansigan, Francisco J. Hernandez-Ilizaliturri, Lisa X. Lee, Stefan K. Barta, Shruthi Melinamani, Reem Karmali, Camille Adeimy, Scott Smith, Neil Dalal, Chadi Nabhan, David Peace, Julie VoseAndrew M. Evens, Namrata Shah, Timothy S. Fenske, Andrew D. Zelenetz, Daniel J. Landsburg, Christina Howlett, Anthony Mato, Michael Jaglal, Julio C. Chavez, Judy P. Tsai, Nishitha Reddy, Shaoying Li, Caitlin Handler, Christopher R. Flowers, Jonathon B. Cohen, Kristie A. Blum, Kevin Song, Haowei Sun, Oliver Press, Ryan Cassaday, Jesse Jaso, L. Jeffrey Medeiros, Aliyah R. Sohani, Jeremy S. Abramson

*Corresponding author for this work

Research output: Contribution to journalArticle

232 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2354-2361
Number of pages8
JournalBlood
Volume124
Issue number15
DOIs
StatePublished - Oct 9 2014

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    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., ... Abramson, J. S. (2014). Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis. Blood, 124(15), 2354-2361. https://doi.org/10.1182/blood-2014-05-578963