Outcomes of Patients with Primary Mediastinal B-Cell Lymphoma Treated with Dose Adjusted R-EPOCH Regimen: A Single Centre Experience

• Published in: Indian journal of hematology & blood transfusion Vol. 37; no. 3; pp. 379 - 385
• Main Authors: Jain, Hasmukh, Kapoor, Akhil, Sengar, Manju, Chanana, Raajit, Menon, Hari, Sridhar, Epari, Laskar, Siddhartha, Agarwal, Archi, Shastri, Jayant, Khanna, Nehal, Rangarajan, Venkatesh, Bagal, Bhausaheb, Thorat, Jayashree, Shet, Tanuja, Gujral, Sumeet
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.07.2021; Springer Nature B.V
• Subjects: Blood Transfusion Medicine; Blood transfusions; Chemotherapy; Clinical outcomes; Drug dosages; Hematology; Human Genetics; Immunotherapy; Lymphoma; Medicine; Medicine & Public Health; Oncology; Original; Original Article; Radiation therapy; Survival analysis; Targeted cancer therapy; Survival outcomes; Dose adjusted R-EPOCH; Mediastinal lymphoma; Mediastinal radiotherapy; Chemo-immunotherapy
• ISSN: 0971-4502; 0974-0449; 0974-0449; 0971-4502
• DOI: 10.1007/s12288-020-01372-y

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.