Published in:
01-07-2021 | Lymphoma | Original Article
Outcomes of Patients with Primary Mediastinal B-Cell Lymphoma Treated with Dose Adjusted R-EPOCH Regimen: A Single Centre Experience
Authors:
Hasmukh Jain, Akhil Kapoor, Manju Sengar, Raajit Chanana, Hari Menon, Epari Sridhar, Siddhartha Laskar, Archi Agarwal, Jayant Shastri, Nehal Khanna, Venkatesh Rangarajan, Bhausaheb Bagal, Jayashree Thorat, Tanuja Shet, Sumeet Gujral
Published in:
Indian Journal of Hematology and Blood Transfusion
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Issue 3/2021
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Abstract
Introduction
Primary Mediastinal B cell lymphoma (PMBCL) is a biologically and clinically distinct subset of diffuse large B cell lymphoma. We analysed the outcomes of our cohort of PMBCL patients treated with Dose adjusted (DA)-R-EPOCH regimen.
Patients and Methods
This is a retrospective analysis of consecutive PMBCL patients who received chemotherapy consisting of DA-R-EPOCH with filgrastim support. Survival analysis was done using Kaplan–Meier method. All calculations were performed using SPSS version 20 for windows.
Results
A total of 43 consecutive suspected PMBCL patients were reviewed for this study, 6 patients were excluded as diagnosis of PMBCL could not be established. All patients except one (97.3%) received 6 cycles of R-DA-EPOCH regimen. Median age of the patients was 27 years (range 15–58). Bulky disease (> 7 cm) was present in 97% patients and 54% patients had extranodal disease. With a median follow up of 40 months, 3-year overall survival was 80.6% (95% CI: 74.0–87.2). The 3-year event free survival was 78.4% (95% CI: 71.6–85.2). There were 6 (16.2%) relapses, 1 (2.7%) primary progression and 7 (23%) deaths. Mediastinal radiotherapy was administered to 17 (45.9%) patients. All the deaths were due to disease progression. Grade III/IV toxicities were seen in 28 (75.7%) patients, febrile neutropenia being the most common one.
Conclusions
DA-R-EPOCH regimen is an effective and tolerable regimen in PMBCL patients even with adverse features.