Long-term follow-up of dose-adjusted EPOCH plus rituximab (DA-EPOCH-R) in untreated patients with poor prognosis large B-cell lymphoma. A phase II study conducted by the Spanish PETHEMA Group

Noelia Purroy, Juan Bergua, Laura Gallur, Julio Prieto, Luis A. Lopez, Juan M. Sancho, Jose A. García-Marco, Josep Castellví, Santiago Montes-Moreno, Ana Batlle, Sonia Gonzalez de Villambrosia, Fernando Carnicero, Lucía Ferrando-Lamana, Miguel A. Piris, Andrés Lopez

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30 Citations (Scopus)

Abstract

© 2014 John Wiley & Sons Ltd. This prospective multi-institutional phase II study was designed to assess the efficacy and safety of dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin) plus rituximab (DA-EPOCH-R) in untreated patients with poor prognosis large B-cell lymphomas. Eighty-one patients diagnosed with diffuse large B-cell lymphoma (DLBCL, n = 68), primary mediastinal DLBCL (n = 6) and follicular lymphoma Grade 3b (n = 7), with an age-adjusted International Prognostic Index >1, were eligible for analysis. Median age was 60 years (range: 21-77). Sixty-five patients (80·2%) achieved complete response. After a median follow-up time of 64 months, 10-year event-free survival and overall survival (OS) were 47·8% and 63·6%, respectively. None of the studied clinical and biological characteristics were associated with poorer outcome. Interestingly, patients with BCL6 rearrangement achieved a 10-year OS of 100%, while patients with BCL2 rearrangement exhibited a poorer outcome compared to activated B-cell tumours and germinal centre B-cell without BCL2 rearranged tumours. Results achieved with DA-EPOCH-R showed a good long-term outcome and a tolerable toxicity profile in high-risk large B cell lymphoma patients. Outcome was not affected by tumour cell proliferation or by cell of origin, highlighting the requirement of new biological markers for patient subclassification of high-risk DLBCL patients.
Original languageEnglish
Pages (from-to)188-198
JournalBritish Journal of Haematology
Volume169
Issue number2
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • And rituximab)
  • Cell of origin
  • Cyclophosphamide
  • Dose-adjusted-EPOCH-R (etoposide, prednisone
  • Doxorubicin
  • High-risk patients
  • Large B-cell lymphoma
  • Vincristine

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