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ASTRO 2022: Does Resistant Large B-Cell Lymphoma Pathology Influence the Efficacy of Radiotherapy?

By: Julia Fiederlein
Posted: Tuesday, November 1, 2022

Based on the results of a multicenter retrospective study, which were presented during the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 197), relapsed or refractory large B-cell lymphoma is responsive to radiotherapy. Although MYC, BCL2, and/or BCL6 translocations did not seem to impact responses, Yolanda D. Tseng, MD, of the University of Washington, Seattle, and colleagues suggested this double-hit/triple-hit pathology is associated with an increased risk of local recurrence and may influence the sensitivity of radiotherapy.

The investigators focused on 211 heavily pretreated patients with a known double-hit/triple-hit status who received radiotherapy in the relapsed or refractory setting. Nearly half of this population (49%) was irradiated with curative intent. A total of 90% and 100% of patients irradiated with curative and palliative intent, respectively, had macroscopic disease at the time of radiotherapy.

Similar response rates were reported among patients with and without double-hit/triple-hit pathology (curative: 71.4% vs. 81.2%; palliative: 54.5% vs. 64.7%). Based on a univariate analysis, double-hit/triple-hit pathology was not found to be associated with response in the curative (hazard ratio [HR] = 1.03; P = .91) and palliative (HR = 1.42; P = .29) settings.

After controlling for primary chemorefractory disease and the radiation biologically effective dose, the investigators found that double-hit/triple-hit pathology was associated with an increased risk of local recurrence in patients who were irradiated with curative intent (HR = 2.38; P = .02). At 6 and 12 months, the local recurrence rates were 41% and 45% in patients with double-hit/triple-hit lymphoma and 21% and 30% in those without this pathology, respectively.

Disclosure: For full disclosures of Dr. Tseng, visit

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