Cover Image

Impact of rituximab and radiotherapy on outcome of patients with aggressive B-Cell lymphoma and skeletal iInvolvement

Purpose To study clinical presentation, outcome, and the role of radiotherapy in patients with aggressive B-cell lymphoma and skeletal involvement treated with and without rituximab. Patients and Methods Outcome of patients with skeletal involvement was analyzed in a retrospective study of nine con...

Full description

Saved in:
Bibliographic Details
Main Authors: Held, Gerhard Wolfgang (Author) , Zeynalova, Samira (Author) , Murawski, Niels (Author) , Ziepert, Marita (Author) , Kempf, Barbara (Author) , Viardot, Andreas (Author) , Dreyling, Martin (Author) , Hallek, Michael (Author) , Witzens-Harig, Mathias (Author) , Fleckenstein, Jochen (Author) , Rübe, Christian (Author) , Zwick, Carsten (Author) , Glass, Bertram (Author) , Schmitz, Norbert (Author) , Pfreundschuh, Michael (Author)
Format: Article (Journal)
Language:English
Published: September 23, 2013
In: Journal of clinical oncology
Year: 2013, Volume: 31, Issue: 32, Pages: 4115-4122
ISSN:1527-7755
DOI:10.1200/JCO.2012.48.0467
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1200/JCO.2012.48.0467
Verlag, lizenzpflichtig, Volltext: https://ascopubs.org/doi/10.1200/JCO.2012.48.0467
Get full text
Author Notes:Gerhard Held, Samira Zeynalova, Niels Murawski, Marita Ziepert, Barbara Kempf, Andreas Viardot, Martin Dreyling, Michael Hallek, Mathias Witzens-Harig, Jochen Fleckenstein, Christian Rübe, Carsten Zwick, Bertram Glass, Norbert Schmitz, and Michael Pfreundschuh
Description
Summary:Purpose To study clinical presentation, outcome, and the role of radiotherapy in patients with aggressive B-cell lymphoma and skeletal involvement treated with and without rituximab. Patients and Methods Outcome of patients with skeletal involvement was analyzed in a retrospective study of nine consecutive prospective trials of the German High-Grade Non-Hodgkin lymphoma Study Group. Results Of 3,840 patients, 292 (7.6%) had skeletal involvement. In the MabThera International Trial (MInT) for young good-prognosis patients and the Rituximab With CHOP Over 60 Years (RICOVER-60) study for elderly patients, the randomized addition of rituximab improved event-free survival (EFS; hazard ratio for MInT [HRMInT] = 0.4, P > 001; hazard ratio for RICOVER-60 [HRRICOVER-60] = 0.6, P > .001) and overall survival (OS; HRMInT = 0.4, P < .001; HRRICOVER-60 = 0.7, P = .002) in patients without skeletal involvement, but failed to improve the outcome of patients with skeletal involvement (EFS: HRMInT = 1.4, P = .444; HRRICOVER-60 = 0.8, P = .449; OS: HRMInT = 0.6, P = .449; HRRICOVER-60 = 1.0, P = .935). Skeletal involvement was associated with a worse outcome after cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus rituximab (HREFS = 1.5, P = .048; HROS = 1.1; P = .828), but not after CHOP without rituximab (HREFS = 0.8, P = .181; HROS = 0.7, P = .083). In contrast to rituximab, additive radiotherapy to sites of skeletal involvement was associated with a decreased risk (HREFS = 0.3, P = .001; HROS = 0.5; P = .111). Conclusion Rituximab failed to improve the outcome of patients with diffuse large B-cell lymphoma with skeletal involvement, although our data suggest a beneficial effect of radiotherapy to sites of skeletal involvement. Whether radiotherapy to sites of skeletal involvement can be spared in cases with a negative positron emission tomography after immunochemotherapy should be addressed in appropriately designed prospective trials.
Item Description:Gesehen am 31.03.2021
Physical Description:Online Resource
ISSN:1527-7755
DOI:10.1200/JCO.2012.48.0467

Similar Items