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    Search British Journal of Cancer Help Site Index 28 August 2008 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cancer Research UK


Clinical

British Journal of Cancer (2004) 90, 372-376.
doi:10.1038/sj.bjc.6601460

Primary mediastinal large B-cell lymphoma (PMLBCL): long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B

G Todeschini1, S Secchi1, E Morra2, U Vitolo3, E Orlandi4, F Pasini5, E Gallo3, A Ambrosetti1, C Tecchio1, C Tarella6, A Gabbas7, A Gallamini8,9, L Gargantini2, M Pizzuti10, G Fioritoni10, L Gottin11, G Rossi12, M Lazzarino4, F Menestrina13, M Paulli14, M Palestro15, M G Cabras16, F Di Vito17 and G Pizzolo1

1Department of Hematology, Verona University, Italy

2Department of Hematology, Ospedale Niguarda, Milano, Italy

3Department of Hematology, Ospedale S. Giovanni Battista, Torino, Italy

4Department of Hematology, Pavia University, Italy

5Department of Oncology, Verona University, Italy

6Department of Hematology, Torino University, Italy

7Department of Hematology, Ospedale S. Francesco, Nuoro, Italy

8Department of Hematology, Ospedale Santa Croce, Cuneo, Italy

9Department of Hematology, Ospedale S. Carlo, Potenza, Italy

10Department of Hematology, Ospedale Santo Spirito, Pescara, Italy

11Anesthesiology and Intensive Care Institute, Verona University, Italy

12Department of Hematology, Spedali Riuniti, Brescia, Italy

13Department of Pathology, Verona University, Italy

14Department of Pathology, Pavia University, Italy

15Department of Pathology, Torino University, Italy

16Department of Hematology, Ospedale Businco, Cagliari, Italy

17Department of Oncology, Ospedale Regionale, Aosta, Italy



Correspondence to: G Todeschini, Dipartimento di Medicina Clinica e Sperimentale, Sezione di Ematologia, Università degli Studi di Verona, Piazzale L. Scuro, Verona 37134, Italy. E-mail: giuseppe.todeschini1@tin.it



The optimal treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is still undefined. In the absence of randomised studies, we retrospectively analysed: (a) the effectiveness of two chemotherapy regimens (CHOP vs MACOP-B/VACOP-B) in complete remission (CR) achievement and event-free survival (EFS) and (b) the role of mediastinal involved-field radiotherapy (IF-RT) as consolidation. From 1982 to 1999, 138 consecutive patients affected by PMLBCL were treated in 13 Italian institutions with CHOP (43) or MACOP-B/VACOP-B (95). The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. Complete remission was 51.1% in the CHOP group and 80% in MACOP-B/VACOP-B (P<0.001). Relapse occurred in 22.7% of CHOP- and in 9.2% of MACOP-B/VACOP-B-treated patients (n.s.). Event-free patients were 39.5% in CHOP and 75.7% in the MACOP-B/VACOP-B group (P<0.001). The addition of IF-RT as consolidation improved the outcome, irrespectively of the type of chemotherapy (P=0.04). At a multivariate analysis, achievement of CR (P<0.0001) and type of CT (MACOP-B/VACOP-B) retained the significance for OS (P=0.008) and EFS (P=0.03). In our experience, MACOP-B/VACOP-B appears to positively influence OS and EFS in patients affected by PMLBCL, as compared to CHOP. Consolidation IF-RT on mediastinum further improves the outcome of CR patients.

Keywords: PMLBCL; CHOP; MACOP-B/VACOP-B

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