Central nervous system relapse in younger ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Central nervous system relapse in younger patients with diffuse large B-cell lymphoma: a LYSA and GLA/ DSHNHL analysis.
Auteur(s) :
Thieblemont, C. [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Université Paris Cité [UPCité]
Altmann, B. [Auteur]
Frontzek, F. [Auteur]
Renaud, Loïc [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Université Paris Cité [UPCité]
Chartier, L. [Auteur]
Ketterer, N. [Auteur]
Récher, Christian [Auteur]
Université Toulouse III - Paul Sabatier [UT3]
Service Hématologie - IUCT-Oncopole [CHU Toulouse]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Poeschel, V. [Auteur]
Fitoussi, Olivier [Auteur]
Polyclinique Bordeaux Nord Aquitaine [PBNA]
Held, G. [Auteur]
Casasnovas, O. [Auteur]
Service d'Hématologie Clinique (CHU de Dijon)
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Haioun, C. [Auteur]
CHU Henri Mondor [Créteil]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Morschhauser, Franck [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Glass, B. [Auteur]
Mounier, Nicolas [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Tilly, Hervé [Auteur]
Université de Rouen Normandie [UNIROUEN]
Service d'hématologie [CRLCC Henri Becquerel]
Rosenwald, A. [Auteur]
Ott, G. [Auteur]
Lenz, G. [Auteur]
Molina, Thierry [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Université Paris Cité [UPCité]
Ziepert, M. [Auteur]
Schmitz, N. [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Université Paris Cité [UPCité]
Altmann, B. [Auteur]
Frontzek, F. [Auteur]
Renaud, Loïc [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Université Paris Cité [UPCité]
Chartier, L. [Auteur]
Ketterer, N. [Auteur]
Récher, Christian [Auteur]
Université Toulouse III - Paul Sabatier [UT3]
Service Hématologie - IUCT-Oncopole [CHU Toulouse]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Poeschel, V. [Auteur]
Fitoussi, Olivier [Auteur]
Polyclinique Bordeaux Nord Aquitaine [PBNA]
Held, G. [Auteur]
Casasnovas, O. [Auteur]
Service d'Hématologie Clinique (CHU de Dijon)
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Haioun, C. [Auteur]
CHU Henri Mondor [Créteil]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Morschhauser, Franck [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Glass, B. [Auteur]
Mounier, Nicolas [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Tilly, Hervé [Auteur]
Université de Rouen Normandie [UNIROUEN]
Service d'hématologie [CRLCC Henri Becquerel]
Rosenwald, A. [Auteur]
Ott, G. [Auteur]
Lenz, G. [Auteur]
Molina, Thierry [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Université Paris Cité [UPCité]
Ziepert, M. [Auteur]
Schmitz, N. [Auteur]
Titre de la revue :
BLOOD ADVANCES
Nom court de la revue :
Blood Adv
Numéro :
7
Pagination :
p. 3968–3977
Date de publication :
2023-01-28
ISSN :
2473-9537
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Most patients with diffuse large B-cell lymphoma (DLBCL) can be cured with immunochemotherapy such as R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Patients with progression or relapse in ...
Lire la suite >Most patients with diffuse large B-cell lymphoma (DLBCL) can be cured with immunochemotherapy such as R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Patients with progression or relapse in the central nervous system (CNS) face dismal outcomes. The impact of more aggressive regimens used in frontline therapy has not been systematically investigated in this context. To this end, we analyzed a large cohort of 2203 younger patients with DLBCL treated on 10 German (German Lymphoma Alliance [GLA]/The German High Grade Non-Hodgkin's Lymphoma Study Group [DSHNHL]) and French (The Lymphoma Study Association [LYSA]) prospective phase 2 and 3 trials after first-line therapy with R-CHOP, R-CHOEP (R-CHOP + etoposide), dose-escalated R-CHOEP followed by repetitive stem cell transplantation (R-MegaCHOEP), or R-ACVBP (rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycine, and prednisone) followed by consolidation including multiple drugs crossing the blood-brain barrier (BBB). Patients with DLBCL with an age-adjusted International Prognostic Index (aaIPI) of 0 to 1 showed very low cumulative incidence rates of CNS relapse regardless of first-line therapy and CNS prophylaxis (3-year cumulative incidences 0%-1%). Younger high-risk patients with aaIPI of 2 to 3 had 3-year cumulative incidence rates of 1.6% and 4% after R-ACVBP plus consolidation or R-(Mega)CHO(E)P, respectively (hazard ratio 2.4; 95% confidence interval: 0.8-7.4; P = .118). Thus, for younger high-risk patients, frontline regimens incorporating agents crossing the BBB may reduce often fatal CNS relapse.Lire moins >
Lire la suite >Most patients with diffuse large B-cell lymphoma (DLBCL) can be cured with immunochemotherapy such as R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Patients with progression or relapse in the central nervous system (CNS) face dismal outcomes. The impact of more aggressive regimens used in frontline therapy has not been systematically investigated in this context. To this end, we analyzed a large cohort of 2203 younger patients with DLBCL treated on 10 German (German Lymphoma Alliance [GLA]/The German High Grade Non-Hodgkin's Lymphoma Study Group [DSHNHL]) and French (The Lymphoma Study Association [LYSA]) prospective phase 2 and 3 trials after first-line therapy with R-CHOP, R-CHOEP (R-CHOP + etoposide), dose-escalated R-CHOEP followed by repetitive stem cell transplantation (R-MegaCHOEP), or R-ACVBP (rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycine, and prednisone) followed by consolidation including multiple drugs crossing the blood-brain barrier (BBB). Patients with DLBCL with an age-adjusted International Prognostic Index (aaIPI) of 0 to 1 showed very low cumulative incidence rates of CNS relapse regardless of first-line therapy and CNS prophylaxis (3-year cumulative incidences 0%-1%). Younger high-risk patients with aaIPI of 2 to 3 had 3-year cumulative incidence rates of 1.6% and 4% after R-ACVBP plus consolidation or R-(Mega)CHO(E)P, respectively (hazard ratio 2.4; 95% confidence interval: 0.8-7.4; P = .118). Thus, for younger high-risk patients, frontline regimens incorporating agents crossing the BBB may reduce often fatal CNS relapse.Lire moins >
Langue :
Anglais
Comité de lecture :
Oui
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CHU Lille
CHU Lille
Collections :
Date de dépôt :
2023-05-25T02:18:27Z
2023-12-04T18:20:17Z
2023-12-04T18:20:17Z