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Leo I. Gordon, MD, FACP


R-CHOP as Front-Line Therapy for Primary Mediastinal LBCL: A View From Jordan

By: Emily Rhode
Posted: Tuesday, April 4, 2023

Mohammad Ma’koseh, MD, of the King Hussein Cancer Center, Amman, Jordan, and colleagues assessed the efficacy of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as a front-line therapy for adults with primary mediastinal large B-cell lymphoma (LBCL) who were treated at their institution. The results of this study suggest that this combination, although suboptimal, may achieve good long-term survival outcomes in patients who have low International Prognostic Index (IPI) scores. These findings were published in the Journal of Blood Medicine.

“Adapting more intensive chemoimmunotherapy regimens may be considered for patients with [a] high IPI [score],” the investigators suggested.

The retrospective study included 49 patients with primary mediastinal LBCL treated with R-CHOP between January 2011 and July 2020, as recorded in the Cancer Registry of King Hussein Cancer Center. Of them, 35 (71.4%) had an IPI of 0 to 1. The median patient age was 29 years, and the median follow-up was 46 months.

Patients received either six cycles of R-CHOP (n = 39; 79.6%) or seven to eight cycles (n = 10; 20.4%). Radiotherapy was administered to 32 patients (65.3%). The overall survival rate was 71.4%. The 4-year progression-free survival was 60%. End-of-treatment complete response, partial response, and progressive disease were seen in 65.3%, 16.3%, and 18.4% of patients, respectively. The 4-year overall response was higher in patients who achieved an end-of-treatment complete response than in those who did not (92.5% vs. 26.9%). Salvage chemotherapy was given to 19 patients with relapsed or refractory disease, with 5 achieving a complete or partial response. An IPI score of at least 1 was significantly associated with progression-free survival (P = .004), overall survival (P = .019), and end-of-treatment response (P = .009).

Disclosure: The study authors reported no conflicts of interest.

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