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Lymphoma

Prolonged survival in poor-risk diffuse large B-cell lymphoma following front-line treatment with rituximab-supplemented, early-intensified chemotherapy with multiple autologous hematopoietic stem cell support: a multicenter study by GITIL (Gruppo Italiano Terapie Innovative nei Linfomi)

Leukemia volume 21, pages 1802–1811 (2007)Cite this article

Abstract

A prospective multicenter program was performed to evaluate the combination of rituximab and high-dose (hd) sequential chemotherapy delivered with multiple autologous peripheral blood progenitor cell (PBPC) support (R-HDS-maps regimen) in previously untreated patients with diffuse large B-cell lymphoma (DLB-CL) and age-adjusted International Prognostic Score (aaIPI) score 2-3. R-HDS-maps includes: (i) three APO courses; (ii) sequential administration of hd-cyclophosphamide (CY), hd-Ara-C, both supplemented with rituximab, hd-etoposide/cisplatin, PBPC harvests, following hd-CY and hd-Ara-C; (iii) hd-mitoxantrone (hd-Mito)/L-Pam + 2 further rituximab doses; (iv) involved-field radiotherapy. PBPC rescue was scheduled following Ara-C, etoposide/cisplatin and Mito/L-Pam. Between 1999 and 2004, 112 consecutive patients aged <65 years (74 score 2, 38 score 3) entered the study protocol. There were five early and two late toxic deaths. Overall 90 patients (80%) reached clinical remission (CR); at a median 48 months follow-up, 87 (78%) patients are alive, 82 (73%) in continuous CR, with 4 year overall survival (OS) and event-free survival (EFS) projections of 76% (CI 68–85%) and 73% (CI 64–81%), respectively. There were no significant differences in OS and EFS between subgroups with Germinal-Center and Activated B-cell phenotype. Thus, life expectancy of younger patients with aaIPI 2-3 DLB-CL is improved with the early administration of rituximab-supplemented intensive chemotherapy compared with the poor outcome following conventional chemotherapy.

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References

  1. Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002; 346: 235–242.

    Article  CAS  Google Scholar 

  2. Pfreundschuh M, Trumper L, Osterborg A, Pettengell R, Trneny M, Imrie K, et al., MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol 2006; 7: 379–391.

    Article  CAS  Google Scholar 

  3. Mounier N, Briere J, Gisselbrecht C, Emile JF, Lederlin P, Sebban C et al. Rituximab plus CHOP (R-CHOP) overcomes bcl-2–associated resistance to chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL). Blood 2003; 101: 4279–4284.

    Article  CAS  Google Scholar 

  4. Feugier P, Van Hoof A, Sebban C, Solal-Celigny P, Bouabdallah R, Ferme C et al. Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol 2005; 23: 4117–4126.

    Article  CAS  Google Scholar 

  5. Tarella C, Gianni AM . BMT for Lymphoma CR1. Curr Opin Oncol 2005; 17: 99–105.

    Article  Google Scholar 

  6. Gisselbrecht C, Mounier N . Managing large cell lymphoma. Symposium article. Ann Oncol 2006; 17 (Suppl 4): iv4–iv11.

    Google Scholar 

  7. Glass B, Kloess M, Bentz M, Schlimok G, Berdel WE, Feller A, et al., German High-Grade Non-Hodgkin Lymphoma Study Group. Dose-escaleted CHOP plus etoposide (MegaCHOEP) followed by repeated stem cell transplantation for primary treatment of aggressive high-risk non-Hodgkin lymphoma. Blood 2006; 107: 3058–3064.

    Article  CAS  Google Scholar 

  8. Stewart DA, Bahlis N, Valentine K, Balogh A, Savoie L, Morris DG et al. Upfront double high-dose chemotherapy with DICEP followed by BEAM and autologous stem cell transplantation for poor-prognosis aggressive non-Hodgkin lymphoma. Blood 2006; 107: 4623–4627.

    Article  CAS  Google Scholar 

  9. Voso MT, Pantel G, Weis M, Schmidt P, Martin S, Moos M et al. In vivo depletion of B cells using a combination of high-dose cytosine arabinoside/mitoxantrone and rituximab for autografting in patients with non-Hodgkin's lymphoa. Br J Haematol 2000; 109: 729–735.

    Article  CAS  Google Scholar 

  10. Magni M, Di Nicola M, Devizzi L, Matteucci P, Lombardi F, Gandola L et al. Successful in vivo purging of CD34-containing peripheral blood harvests in mantle cell and indolent lymphoma: evidence for a role of both chemotherapy and rituximab infusion. Blood 2000; 96: 864–869.

    CAS  PubMed  Google Scholar 

  11. Flinn IW, O’Donnell PV, Goodrich A, Vogelsang G, Abrams R, Noga S et al. Immunotherapy with rituximab during peripheral blood stem cell transplantation for non-Hodgkin's lymphoma. Biol Blood Marrow Transplant 2000; 6: 628–632.

    Article  CAS  Google Scholar 

  12. Ladetto M, Zallio F, Vallet S, Ricca I, Cuttica A, Caracciolo D et al. Concurrent administration of high-dose chemotherapy and rituximab is a feasible and effective chemo/immunotherapy for patients with high-risk non-Hodgkin's lymphoma. Leukemia 2001; 15: 1941–1949.

    Article  CAS  Google Scholar 

  13. Belhadj K, Delfau-Larue MH, Elgnaoui T, Beaujean F, Beaumont JL, Pautas C et al. Efficiency of in vivo purging with rituximab prior to autologous peripheral blood progenitor cell transplantation in B-cell non-Hodgkin's lymphoma: a single institution study. Ann Oncol 2004; 15: 504–510.

    Article  CAS  Google Scholar 

  14. Gianni AM, Bonadonna G . High dose chemoradiotherapy for sensitive tumors: is sequential better than concurrent drug delivery ? Eur J Cancer Clin Oncol 1989; 25: 1027–1030.

    Article  CAS  Google Scholar 

  15. Gianni AM, Siena S, Bregni M, Tarella C, Stern AC, Pileri A, Bonadonna G . Granulocyte-macrophage colony-stimulating factor to harvest circulating hematopoietic stem cells for autotransplantation. Lancet 1989; ii: 580–585.

    Article  Google Scholar 

  16. Gianni AM, Bregni M, Siena S, Brambilla C, Di Nicola M, Lombardi F et al. High-dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma. N Engl J Med 1997; 336: 1290–1297.

    Article  CAS  Google Scholar 

  17. Tarella C, Cuttica A, Caracciolo D, Zallio F, Ricca I, Bergui L et al. High-dose sequential (HDS) chemotherapy for high-risk non-Hodgkin's lymphoma: long-term analysis and future developments. Ann Hematol 2001; 80 (Suppl 3): B123–B126, Review.

    CAS  PubMed  Google Scholar 

  18. Tarella C, Cuttica A, Vitolo U, Liberati M, Di Nicola M, Cortelazzo S et al. High-dose sequential chemotherapy and peripheral blood progenitor cell (PBPC) autografting in refractory/relapsed Hodgkin's lymphoma: a multicenter study of the Intergruppo Italiano Linfomi (Iil) showing prolonged disease-free survival in patients treated at first relapse. Cancer 2003; 97: 2748–2759.

    Article  CAS  Google Scholar 

  19. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML et al. A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994; 84: 1361–1392.

    CAS  Google Scholar 

  20. Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J et al. The World Health Organization classification of neoplastic diseases of the haematopoietic and lymphoid tissues: report of the Clinical Advisory Committee Meeting, Airlie House, Virginia, November 1997. Histopathology 2000; 36: 69–86.

    Article  CAS  Google Scholar 

  21. Hedvat CV, Hegde A, Chaganti RS, Chen B, Qin J, Filippa DA et al. Application of tissue microarray technology to the study of non-Hodgkin's and Hodgkin's lymphoma. Hum Pathol 2002; 33: 968–974.

    Article  Google Scholar 

  22. Pileri SA, Dirnhofer S, Went P, Ascani S, Sabattini E, Marafioti T et al. Diffuse large B-cell lymphoma: one or more entities? Present controversies and possible tools for its subclassification. Histopathology 2002; 41: 482–509.

    Article  CAS  Google Scholar 

  23. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood 2004; 103: 275–282.

    Article  CAS  Google Scholar 

  24. Weinstein HJ, Cassady JR, Levey R . Long term results of the APO protocol (vincristine, doxorubicin, and prednisone) for treatment of mediastinal lymphoblastic lymphoma. J Clin Oncol 1983; 1: 537–541.

    Article  CAS  Google Scholar 

  25. Tarella C, Zallio F, Caracciolo D, Cuttica A, Corradini P, Gavarotti P et al. High-dose mitoxantrone + melphalan (MITO/L-PAM) as conditioning regimen supported by peripheral blood progenitor cell (PBSC) autograft in 113 lymphoma patients: high tolerability with reversible cardiotoxicity. Leukemia 2001; 15: 256–263.

    Article  CAS  Google Scholar 

  26. Tarella C, Castellino C, Locatelli F, Caracciolo D, Corradini P, Falda M et al. G-CSF administration following peripheral blood progenitor cell (PBPC) autograft in lymphoid malignancies: evidence for clinical benefits and reduction of treatment costs. Bone Marrow Transplant 1998; 21: 401–407.

    Article  CAS  Google Scholar 

  27. Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17: 1244–1253.

    Article  CAS  Google Scholar 

  28. Kaplan E, Meier P . Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457–481.

    Article  Google Scholar 

  29. Tarella C, Di Nicola M, Caracciolo D, Zallio F, Cuttica A, Omedè P et al. High-dose Ara-C with autologous peripheral blood progenitor cell support induces a marked progenitor cell mobilization: an indication for patients at risk for low mobilization. Bone Marrow Transplant 2002; 30: 725–732.

    Article  CAS  Google Scholar 

  30. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med 1993; 329: 987–994.

    Article  Google Scholar 

  31. Shipp MA . Prognostic factors in Aggressive Non-Hodgkin's lymphoma: who has “high-risk” disease? Blood 1994; 83: 1165–1173.

    CAS  PubMed  Google Scholar 

  32. Pfreundschuh M, Trumper L, Kloess M, Schmits R, Feller AC, Rube C, et al., German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood 2004; 104: 626–633.

    Article  CAS  Google Scholar 

  33. Shipp MA, Abeloff MD, Antman KH, Carroll G, Hagenbeek A, Loeffler M et al. International Consensus Conference on High-Dose Therapy with Hematopoietic Stem Cell Transplantation in Aggressive Non-Hodgkin's Lymphomas: report of the jury. J Clin Oncol 1999; 17: 423–429.

    Article  CAS  Google Scholar 

  34. Haioun C, Lepage E, Gisselbrecht C, Salles G, Coiffier B, Brice P et al. Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin's lymphoma: final analysis of the prospective LNH87-2 protocol – a groupe d’Etude des lymphomes de l’Adulte study. J Clin Oncol 2000; 18: 3025–3030.

    Article  CAS  Google Scholar 

  35. Milpied N, Deconinck E, Gaillard F, Delwail V, Foussard C, Berthou C et al. Groupe Ouest-Est des Leucemies et des Autres Maladies du Sang. Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med 2004; 350: 1287–1295.

    Article  CAS  Google Scholar 

  36. Strehl J, Mey U, Glasmacher A, Djulbegovic B, Mayr C, Gorschluter M et al. High-dose chemotherapy followed by autologous stem cell transplantation as first-line therapy in aggressive non-Hodgkin's lymphoma: a meta-analysis. Haematologica 2003; 88: 1304–1315.

    CAS  PubMed  Google Scholar 

  37. Schmitz N, Linch DC, Dreger P, Goldstone AH, Boogaerts MA, Ferrant A et al. Randomised trial of filgrastim-mobilised peripheral blood progenitor cell transplantation versus autologous bone marrow transplantation in lymphoma patients. Lancet 1996; 347: 353–357.

    Article  CAS  Google Scholar 

  38. Hartmann O, Le Corroller AG, Blaise D, Michon J, Philip I, Norol F et al. Peripheral blood stem cell and bone marrow transplantation for solid tumors and lymphoma: hematologic recovery and cost. Ann Intern Med 1997; 126: 600–607.

    Article  CAS  Google Scholar 

  39. Majolino I, Pearce R, Taghipour G, Goldstone AH . Peripheral blood stem cell transplantation versus autologous bone marrow transplantation in Hodgkin's lymphoma: a new matched-pair analysis of the European group for blood and marrow transplantation registry data. J Clin Oncol 1997; 15: 509–517.

    Article  CAS  Google Scholar 

  40. Salles G, Coiffier B . Autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma. Baillieres Best Pract Res Clin Haematol 1999; 12: 151–169.

    Article  CAS  Google Scholar 

  41. Kluin-Nelemans HC, Zagonel V, Anastasopoulou A, Bron D, Roozendaal KJ, Noordijk EM et al. Standard chemotherapy with or without high-dose chemotherapy for aggressive non-Hodgkin's lymphoma: randomized phase III EORTC study. J Natl Cancer Inst 2001; 93: 22–30.

    Article  CAS  Google Scholar 

  42. Dervite I, Hober D, Morel P . Acute hepatitis B in a patient with antibodies to hepatitis B surface antigen who was receiving rituximab. N Engl J Med 2001; 344: 68–69.

    Article  CAS  Google Scholar 

  43. Suzan F, Ammor M, Ribrag V . Fatal reactivation of cytomegalovirus infection after use of rituximab for a post-transplantation lymphoproliferative disorder. N Engl J Med 2001; 345: 1000.

    Article  CAS  Google Scholar 

  44. Goldberg SL, Pecora AL, Alter RS, Kroll MS, Rowley SD, Waintraub SE et al. Unusual viral infections (progressive multifocal leukoencephalopathy and cytomegalovirus disease) after high-dose chemotherapy with autologous blood stem cell rescue and peritransplantation rituximab. Blood 2002; 99: 1486–1488.

    Article  CAS  Google Scholar 

  45. Matteucci P, Magni M, Di Nicola M, Carlo-Stella C, Uberti C, Gianni AM . Leukoencephalopathy and papovavirus infection after treatment with chemotherapy and anti-CD20 monoclonal antibody. Blood 2002; 100: 1104–1105.

    Article  Google Scholar 

  46. Quartier P, Tournilhac O, Archimbaud C, Lazaro L, Chaleteix C, Millet P et al. Enteroviral meningoencephalitis after anti-CD20 (rituximab) treatment. Clin Infect Dis 2003; 36: e47–e49.

    Article  Google Scholar 

  47. Sirvent-Von Bueltzingsloewen A, Sirvent N, Morand P, Cassuto JP . Fatal central nervous system lesions emerging during anti-CD20 monoclonal antibody therapy (Rituximab) for a post transplantation Epstein—Barr virus-linked lymphoma. Med Pediatr Oncol 2003; 40: 408–409.

    Article  Google Scholar 

  48. Isobe Y, Sugimoto K, Shiraki Y, Nishitani M, Koike K, Oshimi K . Successful high-titer immunoglobulin therapy for persistent parvovirus B19 infection in a lymphoma patient treated with rituximab-combined chemotherapy. Am J Hematol 2004; 77: 370–373.

    Article  Google Scholar 

  49. Sarrecchia C, Cappelli A, Aiello P . HBV reactivation with fatal fulminating hepatitis during rituximab treatment in a subject negative for HBsAg and positive for HBsAb and HBcAb. J Infect Chemother 2005; 11: 189–191.

    Article  Google Scholar 

  50. Cuttica A, Zallio F, Ladetto M, Di Nicola M, Caracciolo D, Magni M et al. Patients with high-risk aggressive lymphoma treated with frontline intensive chemotherapy and autografting: Evidence of marked differences in outcome between patients with age-adjusted International Prognostic Index scores 2 and 3. Cancer 2003; 98: 983–992.

    Article  CAS  Google Scholar 

  51. Vitolo U, Bertini M, Brusamolino E, Cavallero GB, Comotti B, Gallo E et al. MACOP-B treatment in diffuse large-cell lymphoma: identification of prognostic groups in an Italian multicenter study. J Clin Oncol 1992; 10: 219–227.

    Article  CAS  Google Scholar 

  52. Yan Y, Chan WC, Weisenburger DD, Anderson JR, Bast MA, Vose JM et al. Clinical and prognostic significance of bone marrow involvement in patients with diffuse aggressive B-cell lymphoma. J Clin Oncol 1995; 13: 1336–1342.

    Article  CAS  Google Scholar 

  53. Perea G, Altes A, Bellido M, Aventin A, Bordes R, Ayats R et al. Clinical utility of bone marrow flow cytometry in B-cell non-Hodgkin lymphomas (B-NHL). Histopathology 2004; 45: 268–274.

    Article  CAS  Google Scholar 

  54. Colomo L, Lopez-Guillermo A, Perales M, Rives S, Martinez A, Bosch F et al. Clinical impact of the differentiation profile assessed by immunophenotyping in patients with diffuse large B-cell lymphoma. Blood 2003; 101: 78–84.

    Article  CAS  Google Scholar 

  55. van Imhoff GW, Boerma EJ, van der Holt B, Schuuring E, Verdonck LF, Kluin-Nelemans HC et al. Prognostic impact of germinal center-associated proteins and chromosomal breakpoints in poor-risk diffuse large B-cell lymphoma. J Clin Oncol 2006; 24: 4135–4142.

    Article  CAS  Google Scholar 

  56. Horwitz SM, Negrin RS, Blume KG, Breslin S, Stuart MJ, Stockerl-Goldstein KE et al. Rituximab as adjuvant to high-dose therapy and autologous hematopoietic cell transplantation for aggressive non-Hodgkin lymphoma. Blood 2004; 103: 777–783.

    Article  CAS  Google Scholar 

  57. Khouri IF, Saliba RM, Hosing C, Okoroji GJ, Acholonu S, Anderlini P et al. Concurrent administration of high-dose rituximab before and after autologous stem-cell transplantation for relapsed aggressive B-cell non-Hodgkin's lymphomas. J Clin Oncol 2005; 23: 2240–2247.

    Article  CAS  Google Scholar 

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Acknowledgements

Investigators from the following Institutions in Italy contributed to the trial: Divisione Universitaria di Ematologia, A.S.O. S. Giovanni B., Torino: C Tarella, D Caracciolo, ML, I Ricca, MZ, MB; Divisione di Oncologia Medica and Divisione di Ematologia, Istituto Nazionale Tumori, Milano: AMG, PC, MDiN, MM, LD, F Zallio; Divisione di Ematologia, A.S.O. V.Cervello (Palermo): SM, CP, R Scimé, AC; Divisione di Ematologia, A.S.O. S. Croce, Cuneo: AG, RC, C Castellino; Bone Marrow Trasplantation Unit, Istituto Scientifico H. S. Raffaele (Milano): AP, MB; Divisione di Ematologia, A.S.O. S. Camillo-Forlanini, Roma: IM, VZ; Istituti di Anatomia Patologica di, Università di Torino: G Inghirami, DN, AF; Istituto Nazionale Tumori, Milano: A Carbone, AC; A.S.O. V. Cervello, Palermo: A Rizzo, MS; A.S.O. S. Croce, Cuneo: AC; A.S.O. S. Camillo-Forlanini, Roma: RP, DR; Istituto Scientifico H. S. Raffaele, Milano: C Doglioni, M Ponzoni. This work was supported in part by grants from: Ministero dell’Istruzione, dell’Università e della Ricerca (MIUR); the Michelangelo Foundation for Advances in Cancer Research and Treatment; the Piedmont Regional Government (Regione Piemonte). We thank Professor Giorgio Inghirami for helpful suggestions and assistance in the pathological review and immunohistochemical reassessment.

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Authors and Affiliations

  1. Divisione Universitaria di Ematologia, Dip Medicina-Oncologia Sperimentale, Torino, Italy

    C Tarella, M Zanni, D Caracciolo, M Ladetto & M Boccadoro

  2. Divisione di Oncologia Medica, I.N.T. and Università di Milano, Milano, Italy

    M Di Nicola, M Magni, L Devizzi & A M Gianni

  3. Divisione di Ematologia, Azienda Ospedaliera V. Cervello, Palermo, Italy

    C Patti & S Mirto

  4. Divisione di Ematologia, Azienda Ospedaliera S. Croce, Cuneo, Italy

    R Calvi & A Gallamini

  5. Bone Marrow Transplantation Unit, IRCCS H. S. Raffaele, Milano, Italy

    A Pescarollo & M Bregni

  6. Divisione di Ematologia, Ospedale S. Camillo-Forlanini, Roma, Italy

    V Zoli & I Majolino

  7. Center for Experimental Research and Medical Studies (CERMS), Ist. Univ. Anatomia Patologica, Torino, Italy

    A Fornari & D Novero

  8. Ist. Anatomia Patologica, Istituto Nazionale Tumori, Milano, Italy

    A Cabras

  9. Ist. Anatomia Patologica, Azienda Ospedaliera V. Cervello, Palermo, Italy

    M Stella

  10. Ist. Anatomia Patologica, Azienda Ospedaliera S. Croce, Cuneo, Italy

    A Comino

  11. Ist. Anatomia Patologica, Ospedale S. Camillo-Forlanini, Roma, Italy

    D Remotti

  12. Ist. Anatomia Patologica, IRCCS H. S. Raffaele, Milano, Italy

    M Ponzoni

  13. Servizio di Epidemiologia dei Tumori, Università di Torino, Torino, Italy

    R Rosato

  14. Divisione di Ematologia, I.N.T. and Università di Milano, Milano, Italy

    P Corradini

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Tarella, C., Zanni, M., Di Nicola, M. et al. Prolonged survival in poor-risk diffuse large B-cell lymphoma following front-line treatment with rituximab-supplemented, early-intensified chemotherapy with multiple autologous hematopoietic stem cell support: a multicenter study by GITIL (Gruppo Italiano Terapie Innovative nei Linfomi). Leukemia 21, 1802–1811 (2007). https://doi.org/10.1038/sj.leu.2404781

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