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A Cancer and Leukemia Group B multi-center study of DA-EPOCH-rituximab in untreated diffuse large B-cell lymphoma with analysis of outcome by molecular subtype.

Publication ,  Journal Article
Wilson, WH; Jung, S-H; Porcu, P; Hurd, D; Johnson, J; Martin, SE; Czuczman, M; Lai, R; Said, J; Chadburn, A; Jones, D; Dunleavy, K; Hsi, ED ...
Published in: Haematologica
May 2012

BACKGROUND: A phase II trial of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab (DA-EPOCH-R) from the National Cancer Institute showed promising activity in untreated diffuse large B-cell lymphoma. The Cancer and Leukemia Group B conducted a study to determine if these results could be reproduced in a multi-institutional setting. DESIGN AND METHODS: The study included 69 patients with untreated diffuse large B-cell lymphoma at least 18 years of age and at least stage II. Radiaton therapy was not permitted on study. Median age was 58 years (range 23-83) and 40% had high-intermediate or high International Prognostic Index risk. Immunohistochemical biomarkers for cell of origin and proliferation were performed. RESULTS: With a median follow up of 62 months, time to progression and overall survival were 81% and 84%, respectively, and time to progression was 87%, 92% and 54% for low/low-intermediate, high-intermediate and high International Prognostic Index risk groups, respectively, at 5-years and beyond. The time to progression and event-free survival of germinal center B-cell lymphoma were 100% and 94%, respectively, and non-germinal center B-cell GCB diffuse large B-cell lymphoma were 67% and 58%, respectively, at 62 months (germinal center vs. non-germinal center B cell P=0.008). DA-EPOCH-R was tolerated without significant grade 4 non-hematologic toxicities. CONCLUSIONS: These results provide the first confirmation by a multi-institutional group that DA-EPOCH-R provides high durable remissions in diffuse large B-cell lymphoma and is effective in both germinal center and non-germinal center B-cell subtypes. The trial was registered at ClinicalTrials.Gov (NCT00032019).

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Published In

Haematologica

DOI

EISSN

1592-8721

Publication Date

May 2012

Volume

97

Issue

5

Start / End Page

758 / 765

Location

Italy

Related Subject Headings

  • Young Adult
  • Vincristine
  • Survival Rate
  • Rituximab
  • Remission Induction
  • Prognosis
  • Prednisone
  • Neoplasm Staging
  • Middle Aged
  • Mediastinal Neoplasms
 

Citation

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Wilson, W. H., Jung, S.-H., Porcu, P., Hurd, D., Johnson, J., Martin, S. E., … Cancer Leukemia Group B, . (2012). A Cancer and Leukemia Group B multi-center study of DA-EPOCH-rituximab in untreated diffuse large B-cell lymphoma with analysis of outcome by molecular subtype. Haematologica, 97(5), 758–765. https://doi.org/10.3324/haematol.2011.056531
Wilson, Wyndham H., Sin-Ho Jung, Pierluigi Porcu, David Hurd, Jeffrey Johnson, S Eric Martin, Myron Czuczman, et al. “A Cancer and Leukemia Group B multi-center study of DA-EPOCH-rituximab in untreated diffuse large B-cell lymphoma with analysis of outcome by molecular subtype.Haematologica 97, no. 5 (May 2012): 758–65. https://doi.org/10.3324/haematol.2011.056531.
Wilson WH, Jung S-H, Porcu P, Hurd D, Johnson J, Martin SE, et al. A Cancer and Leukemia Group B multi-center study of DA-EPOCH-rituximab in untreated diffuse large B-cell lymphoma with analysis of outcome by molecular subtype. Haematologica. 2012 May;97(5):758–65.
Wilson, Wyndham H., et al. “A Cancer and Leukemia Group B multi-center study of DA-EPOCH-rituximab in untreated diffuse large B-cell lymphoma with analysis of outcome by molecular subtype.Haematologica, vol. 97, no. 5, May 2012, pp. 758–65. Pubmed, doi:10.3324/haematol.2011.056531.
Wilson WH, Jung S-H, Porcu P, Hurd D, Johnson J, Martin SE, Czuczman M, Lai R, Said J, Chadburn A, Jones D, Dunleavy K, Canellos G, Zelenetz AD, Cheson BD, Hsi ED, Cancer Leukemia Group B. A Cancer and Leukemia Group B multi-center study of DA-EPOCH-rituximab in untreated diffuse large B-cell lymphoma with analysis of outcome by molecular subtype. Haematologica. 2012 May;97(5):758–765.

Published In

Haematologica

DOI

EISSN

1592-8721

Publication Date

May 2012

Volume

97

Issue

5

Start / End Page

758 / 765

Location

Italy

Related Subject Headings

  • Young Adult
  • Vincristine
  • Survival Rate
  • Rituximab
  • Remission Induction
  • Prognosis
  • Prednisone
  • Neoplasm Staging
  • Middle Aged
  • Mediastinal Neoplasms