Long Term Follow-up of the GELF86 French and Belgian Trials: Complete Remission after First Line Treatment with Conventional Chemotherapy in Newly Diagnosed Follicular Lymphoma Patients Correlates with Prolonged Overall Survival Compared with Partial Remission

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2590-2590 ◽  
Author(s):  
E. Bachy ◽  
P. Brice ◽  
M. Fournier ◽  
H. Tilly ◽  
C. Haioun ◽  
...  
Keyword(s):  
Overall Survival ◽  
Complete Remission ◽  
Follicular Lymphoma ◽  
Tumor Burden ◽  
Line Treatment ◽  
Newly Diagnosed ◽  
First Line ◽  
Long Term Follow Up ◽  
First Line Treatment

Abstract Purpose . Frontline treatment for newly diagnosed follicular lymphoma (FL) patients, ranging from watch and wait policy to high-dose therapy, still remains debated, even in the rituximab-based combination therapy era. Few studies have addressed the question whether complete remission (CR) translates into better survival compared to partial remission (PR). The aim of this study was to assess the potential correlation between response quality to first line treatment and overall survival in light of a long-term follow-up. Patients and methods. Data from 536 FL patients, 435 enrolled in the French and Belgian GELF86 trials and 101 additional patients treated with the same chemotherapy regimen (CHVP-IFN or CHVP regimen after the accrual stopping date with prospectively collected data), were analysed in the study. Data from the GELF86 trials have been previously reported: 193 patients had low tumor burden (LTB) (Brice et al., JCO, 1997) and 242 and the aforementioned 101 additional patients had high tumor burden (HTB) at diagnosis (Solal-Céligny et al., NEJM 1993). All patients with at least one criteria for HTB were treated as frontline therapy with an anthracycline based CHVP regimen: cyclophosphamide, doxorubicin, teniposide, and prednisone monthly for 6 months and then every 2 months for 1 more year. Patients were randomly assigned to the CHVP arm (n=153) or the CHVP-IFN arm (n=190) when they also received α-interferon three times weekly for 18 months. Patients with LTB FL were randomly assigned to one of the three arms: arm 1, no initial treatment (n=66); arm 2, prednimustine for 5 days per month for 18 months (n=64); or arm 3, IFN three times per week for 15 months (n=63). Results. Median follow-up was 14.3 years and median overall survival (OS) was 9.8 years for the whole cohort. As expected, the Follicular Lymphoma International Prognostic Index (FLIPI) was a strong prognostic factor as well as bone marrow involvement, erythrocyte sedimentation rate (ESR), and B symptoms in univariate analysis or the FLIPI, lymphocytes count, ESR and male sex in multivariate analysis, respectively. Furthermore, treated patients who achieved a CR (n=170, 40%) had a significant longer OS than those only reaching a PR (n=162, 38%) throughout treatment (10-year OS was 64% (95% CI, 57–71%) for CR patients and 46% (95% CI, 38–54%) for PR patients, logrank p=0.0002). In a subgroup analysis by tumour burden, CR remained highly predictive of a better outcome for HTB patients (logrank p=0.001) but not for LTB patients. No difference was observed between patients who went into early complete remission (≤ 6 months) versus late complete remission (> 6 months). Finally, when only HTB patients receiving CHVP-IFN were compared with those receiving the same treatment in the FL2000 trial (Salles et al., Blood, in press), Cox analysis adjusted for the FLIPI indicated a better outcome for FL2000 patients (HR=0.66, 95% CI 0.44–0.99, p=0.047). Conclusion. These data provide a long follow-up of these patients’ cohorts, and indicate strong evidence that better response to first line treatment translates into a favorable outcome for patients with newly diagnosed FL, especially for HTB patients.

Long-Term Follow-Up of Patients With Newly Diagnosed Follicular Lymphoma in the Prerituximab Era: Effect of Response Quality on Survival—A Study From the Groupe d'Etude des Lymphomes de l'Adulte

2010 ◽  
Vol 28 (5) ◽  
pp. 822-829 ◽  
Author(s):  
Emmanuel Bachy ◽  
Pauline Brice ◽  
Richard Delarue ◽  
Nicole Brousse ◽  
Corinne Haioun ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Tumor Burden ◽  
Line Treatment ◽  
Newly Diagnosed ◽  
First Line ◽  
Response Quality ◽  
Long Term Follow Up ◽  
First Line Treatment

Purpose First-line treatment for patients with newly diagnosed follicular lymphoma (FL) still remains debated, even in the rituximab-based combination therapy era. Few studies have addressed the question whether complete remission (CR) translates into better survival. The aim of this study was to assess the long-term follow-up of prospectively treated patients with FL and the potential correlation between response quality to first-line treatment and overall survival (OS). Patients and Methods Data from 536 patients with FL with low (n = 193) or high (n = 343) tumor burden enrolled from October 1986 to May 1995 in the French and Belgian GELF86 studies were analyzed. Data from these trials have been previously reported for low–tumor burden and high–tumor burden patients. Results Median follow-up was 14.9 years, and median OS was 9.8 years. Treated patients who achieved a complete response (CR; n = 194; 45%) had a significant longer OS than those only reaching a partial response (PR; n = 168; 39%) throughout treatment (hazard ratio [HR], 0.55; 95% CI, 0.42 to 0.72; P < .001) in an univariate time-dependent Cox model. Similar findings were found when response to treatment (CR v PR) was adjusted for potentially confounding factors in a multivariate model (HR, 0.53; 95% CI, 0.38 to 0.73; P < .001). Conclusion These data provide a long follow-up of these patients' cohorts and indicate that a better response to first-line treatment translates into an improved survival for patients with FL. Therefore, response-adapted therapy aiming to achieve a CR should be considered as first-line treatment.

Management of Grade 3B Follicular Lymphoma (FL) Outside Clinical Trials: A Multicentric Retrospective Analysis on Behalf of Fondazione Italiana Linfomi (FIL)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2716-2716
Author(s):  
Barbara Botto ◽  
Federica Cavallo ◽  
Manuela Zanni ◽  
Antonella Anastasia ◽  
Chiara Rusconi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Follicular Lymphoma ◽  
Retrospective Analysis ◽  
Progression Free Survival ◽  
Line Treatment ◽  
First Line ◽  
Free Survival ◽  
Rituximab Maintenance ◽  
First Line Treatment

Abstract Introduction: Follicular lymphoma grade 3 is recognized as a distinct entity in the World Health Organization classification of lymphoma. It is further classified into grade 3a and 3b depending on percentage of centroblasts. There is no consensus about its clinical course because some studies indicate an indolent behavior but others describe a more aggressive. Large systematic studies are missing in particular for 3b follicular lymphoma which is often considered as a separate entity. Methods: We performed a retrospective multicentric study on a group of 3b FL patients diagnosed in nine Italian FIL centers between November 2002 and January 2015. Planned inclusion criteria at enrollment were first line Rituximab containing regimen treatment and diagnostic samples availability for central pathologic review. Aim of the study was to determine clinical response, OS and PFS. Tumor response was based on the International Working Group response criteria. Survival analysis was performed with Kaplan-Meier method. Results: We enrolled a total of 51 patients, 50 evaluable for response at the time of analysis; median age was 62 yrs (range 48-71), 29 (56%) in stage III-IV, 10 (20%) with B symptoms. First line treatment was R-CHOP in the majority of patients 47 (92%), R-Bendamustine and R-CVP in 2 (4%) respectively. Seven patients (14%) received Rituximab maintenance after first line, six (12%) underwent high dose chemotherapy and autologous stem cell transplant (ASCT) as consolidation therapy and 5 (10%) were treated with local radiotherapy on residual disease. We observed CR in 48 patients (96%), PR in 1 (2%), PD in 1(2%). Ten patients relapsed or progressed after first line treatment and four of them died, three for progressive disease and one due to senile dementia while in CR. No relapses were recorded in pts receiving Rituximab maintenance but the advantage was not statistically significant and the number of patients receiving maintenance was low. With a median follow up of 63 months from diagnosis (IQR 33-82), 3-yrs PFS and OS rates were 82% and 93% (fig 1 and 2) with the evidence of a plateau in both survival curves after 5 years observation. Central pathologic review is ongoing. Conclusion: With the limit of a retrospective analysis our study confirms the clinical benefit of a combined modality treatment with Rituximab plus antracycline-containing chemotherapy in patients with 3b FL. Our results compare favorably with those previously reported in studies without Rituximab, that failed to show a plateau with 3-yrs PFS ranging between 22% and 52%. This results need to be confirmed with a longer follow up and after the planned pathologic review. Figure 1. Progression-Free Survival. Median Follow-up 62 months (IQR 33-82). Figure 1. Progression-Free Survival. Median Follow-up 62 months (IQR 33-82). Figure 2. Overall Survival. Median Follow-up 63 months. Figure 2. Overall Survival. Median Follow-up 63 months. Disclosures No relevant conflicts of interest to declare.

The Addition of Thalidomide in Any Line of Treatment of Multiple Myeloma, Improves Overall Survival: Single Center Experience in 246 Patients.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4813-4813
Author(s):  
Eirini Katodritou ◽  
Evgenia Verrou ◽  
Anastasia Banti ◽  
Vassiliki Gastari ◽  
Dimitra Mihou ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Dose ◽  
Line Treatment ◽  
Newly Diagnosed ◽  
First Line ◽  
High Dose Therapy ◽  
Dose Therapy ◽  
Group 2 ◽  
First Line Treatment

Abstract Thalidomide is effective for the treatment of either newly diagnosed or relapsed/refractory multiple myeloma (MM) patients. However, the contribution of Thalidomide to the overall survival in MM has not yet been clarified. The aim of this study was to examine, if the incorporation of Thalidomide either in first or in any line regimens, positively influences overall survival, in a large cohort of MM patients, with a long follow up. Two hundred forty-six newly diagnosed symptomatic MM patients, 139 males and 107 females, with a median age of 67 years (range 29–90) were studied. One hundred ninghty-two patients (group 1A) received regimens not containing Thalidomide as first line treatment (129 received Vincristine /Adriamycin /Dexamethasone, 58 received Melphalan /Prednisone and 5 received Dexamethasone). Fifty-four patients (group 2A) received regimens containing Thalidomide as first line treatment (32 patients received Vincristine /Adriamycin /Dexamethasone /Thalidomide 14 patients Dexamethasone /Thalidomide and 8 patients Melphalan /Prednisone /Thalidomide). One hundred-ninety patients received second or more than second line therapy. One hundred twenty-three patients received standard regimens not containing Thalidomide (group 1B) and 77, regimens containing Thalidomide (group 2B). The standard regimens in group 1B and 2B were similar to first line regimens. Totally, 100 patients received regimens containing Thalidomide at any time of the disease. Twenty and 8 patients in group 1A+1B and 2A+2B, respectively, received high dose therapy. The evaluated parameters, for predicting overall survival were: age, ISS score, creatinine, B2 microglobulin, LDH, Thalidomide-containing regimens in first line (group 2A) and in any line of treatment (group 2, A and B), time to response to first line treatment and quality of response (CR+PR versus less than PR). Cox regression was used for the univariate and multivariate analysis and Mann Whitney-U test and Pearson’s chi square test, for comparisons of patients’ characteristics. The median follow up was 31 months (range 1–231). Patients in both groups were well-balanced concerning age, sex, ISS score, B2-micriglobulin, creatinine and LDH (p<0.05). There was no statistical difference concerning the number of patients who proceeded to high dose therapy in both groups at any time of treatment (P>0.05). The univariate analysis showed that, age, ISS score, creatinine, B2 microglobulin, LDH, Thalidomide-containing regimens either in first or in any line of treatment and time to response to first line treatment, predicted for survival. The multivariate analysis demonstrated that age, ISS score and regimens containing Thalidomide in any line of treatment (group 2, A and B), independently predicted for overall survival (p<0.05). The median survival in the group 1 and 2 was 28mo (SD=35mo) and 34mo (SD=26mo), respectively (p=0.04). This study showed that, the incorporation of Thalidomide in any line of treatment, improves overall survival. Considering that the type of the standard regimens applied, either including or not Thalidomide, were similar and there was no statistical difference in the percentage of patients who underwent high dose therapy, between the two groups, these results produced by the analysis of a large cohort of newly diagnosed MM patients, with a long follow up offer important information about the impact of Thalidomide on the overall survival.

First Line Treatment of Advanced Stage Hodgkin Lymphoma with Six Cycles of BEACOPPescalated Results in Superior Overall Survival Compared to ABVD: Results of a Network Meta-Analysis Including 10,011 Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 551-551
Author(s):  
Peter Borchmann ◽  
Sven Trelle ◽  
Michaela Rancea ◽  
Heinz Haverkamp ◽  
Volker Diehl ◽  
...  
Keyword(s):  
Overall Survival ◽  
Initial Treatment ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Advanced Stage ◽  
Secondary Malignancies ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Abstract Abstract 551 Background: The best treatment strategy for advanced stage Hodgkin lymphoma (HL) is still a matter of debate. The German Hodgkin Study Group (GHSG) advocates aggressive treatment with BEACOPPescalated (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) to cure as many patients as possible with first-line therapy. However, BEACOPPescalated may expose patients to excessive toxicity. Treatment with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) is supposed to be better tolerable. Proponents of primary ABVD therapy acknowledge a lower progression-free survival (PFS) compared to BEACOPPescalated. However, they argue that relapsing patients can subsequently be cured by high-dose chemotherapy resulting in comparable overall survival (OS). All trials evaluating these two strategies directly were either very small or included patient subgroups only. Although they congruently showed a significant PFS advantage for BEACOPPescalated, they were not powered to detect differences in OS, which obviously is the most important endpoint. Purpose: To assess the benefits and risks of different initial treatment strategies for adult patients with advanced stage HL and to provide patients and physicians with a high-level evidence for treatment decisions. Methods: Data Sources: We developed sensitive search strategies for CENTRAL, MEDLINE, and conference proceedings (searched from 01/1980 to 03/2012). Missing data was obtained from investigators. Study selection: Randomized trials that compared at least two out of twelve pre-defined chemotherapy regimens in adults with advanced stage HL. Two authors independently assessed studies for eligibility. Data extraction: We extracted data and assessed quality of trials in duplicate. The primary outcome was OS. Secondary outcomes included freedom-from-treatment failure (FFTF) and secondary malignancies. Data relates to four or five years of follow-up depending on the status of the trial. Data synthesis: We pooled data using network meta-analysis. Direct comparisons within trials were combined with indirect evidence from other trials by using a Bayesian random-effects model. Results are reported relative to ABVD with a hazard ratio (HR) >1 indicating superiority of ABVD. Results: 1,984 references were identified, of which 77 publications, reporting 14 trials, evaluating 11 different regimens were included. A total of 10,011 patients with 59,000 patient-years of follow-up were evaluable for the analyses of survival outcomes. Six cycles of BEACOPPescalated and 8 cycles of BEACOPP-14 were associated with the lowest risk for death of any cause (HR 0.38, 95%-CrI 0.20 to 0.75 and HR 0.43, 95%-CrI 0.22 to 0.86, respectively). Assuming a five-year survival rate of 89% for ABVD this would result in a 5-year survival benefit of 7% and 6% for 6 cycles of BEACOPPescalated and 8 cycles of BEACOPP-14, respectively (95%-CrI 3% to 9% and 2% to 9%, respectively). Eight cycles of BEACOPPescalated were also statistically significantly better as compared to ABVD but the effect was less pronounced. All other treatment strategies showed no statistically significant difference to ABVD. Similar results were obtained for FFTF. Between-trial heterogeneity was negligible in both analyses (tau-square 0.01 and 0.05, respectively). Overall, 327 secondary malignancy and 109 leukemia events accumulated over 57,529 patient-years of follow-up. Given the low number of events we were not able to accurately quantify the risk associated with each regimen; however, Stanford V might be associated with the lowest risk and C(M)OPP/EBV/CAD with the highest risk for secondary leukemias. Limitations: Some of the regimens were only evaluated in one trial. The number of secondary malignancies, especially leukemias, was low. Conclusions: The comparison of different first-line treatment strategies for advanced stage HL in this network meta-analysis shows a significant and relevant OS benefit for both, 6 cycles of BEACOPPescalated and 8 cycles of BEACOPP-14 over standard ABVD treatment. This analysis provides the currently best available evidence on OS of different initial treatment strategies for advanced stage HL patients and therefore adds valid and important information for both, patients and physicians. Disclosures: No relevant conflicts of interest to declare.

Cost-effectiveness of rituximab plus CVP for first-line treatment of advanced indolent lymphoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6583-6583
Author(s):  
J. Hornberger ◽  
C. Reyes ◽  
E. Verhulst ◽  
D. Lubeck ◽  
N. Valente
Keyword(s):  
Overall Survival ◽  
Cost Effectiveness ◽  
Follicular Lymphoma ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Line Treatment ◽  
First Line ◽  
Economic Implications ◽  
The Cost ◽  
First Line Treatment

6583 Background: The addition of rituximab (RTX) to CVP (cyclophosphamide, vincristine, prednisone) in the treatment of advanced follicular lymphoma increases median time to progression by 17 months (15 month v 32 months; p < 0.0001) (Marcus et al, Blood 2005). A societal cost-effectiveness analysis was performed to estimate projected lifetime clinical and economic implications of this treatment. Methods: The cost-effectiveness (CE) of RTX + CVP versus CVP was estimated for a 50 yr old patient. Kaplan-Meier estimates of progression-free and overall survival, up to 4 years, were obtained from the M39021 trial. After 4 years, transition rates from initiation of treatment to progression or death were assumed to be the same in both arms. The clinical and economic implications of relapse and its treatment were included in the model. Incremental costs associated with addition of RTX were estimated using Medicare reimbursement rates and published retail price data. Costs included drug and administration costs, adverse events, treatment of relapses, and end-of-life costs. Utility estimates were derived from the literature and a 3% discount rate was employed. Results: Projected mean overall survival is 1.5 yrs longer for patients assigned to RTX+ CVP versus only CVP (13.7 v 12.2 yrs). The addition of RTX to CVP is estimated to cost an additional $26,439 on average, with an expected gain of 0.85 year of quality-adjusted survival. Over a lifetime, the cost per QALY gained is $31,329. Sensitivity analyses revealed that the variables that most influenced cost-effectiveness were the time horizon (range: $18,800- $31,240) and the unit drug cost of RTX (range: $24,000-$38,000). Conclusion: The model estimates a cost-to-QALY gained ratio that is below that of many treatments used for oncology patients. The use of RTX + CVP for first-line treatment of advanced follicular lymphoma is projected to be cost-effective compared to CVP alone under a range of sensitivity analyses. No significant financial relationships to disclose.

scholarly journals Single Centre Experience of Managing Patients with Double Hit Lymphoma

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5868-5868
Author(s):  
Shankaranarayana Paneesha ◽  
Iman Qureshi ◽  
Malahat Saeed ◽  
Richard Lovell ◽  
Emmanouil Nikolousis ◽  
...  
Keyword(s):  
Overall Survival ◽  
Complete Remission ◽  
Progressive Disease ◽  
Salvage Chemotherapy ◽  
Line Treatment ◽  
First Line ◽  
Single Centre ◽  
Single Centre Experience ◽  
First Line Treatment

Abstract Double or triple hit Lymphomas (DHL) are characterized by translocation rearrangements of C-MYC with the addition of BCL2 and/or BCL 6, which are associated with a poor outcome due to their genetic complexity . Clinical controversies remain regarding the optimum treatment for patients with DHL due to lack of consensus regarding the optimal management and also age and frailty being a significant obstacle, limiting the role of dose-escalated or intensified therapy. Literature review suggests overall median survival for DHL patients is from 0.2-1.5years2. We report our single centre experience of treating this patient group. Materials & Methods: This single centre retrospective study evaluated the outcome of DHL patients who underwent various lines of treatment including standard R-CHOP chemotherapy, more intensive chemotherapy regimens and allogeneic stem cell transplantation (AlloSCT). Diagnosis of DHL was as per the 2008 WHO classification. Statistical analysis was performed by using SPSS 23®. Results: Our study included fourteen patients (9M; 5F) with a median age 60.5 years (range 33-65). 4 patients had stage 2B disease, 3 had stage 3B and 7 had 4B disease. R-CHOP chemotherapy only was commenced as first line treatment in 4 patients, R-CHOP plus intrathecal chemotherapy was given to 2 patients and 1 patient received R-CEOP. 5 patients received intensive chemotherapy with R-CODOX-M/R-IVAC where as one patient received EPOCH in a different centre prior to transfer. 1 patient received radiotherapy only. 10 patients were in complete remission following first line chemotherapy. One patient progressed following first line treatment and was managed palliatively. One patient relapsed whilst awaiting AlloSCT and was given mini-DEX BEAM salvage chemotherapy prior to transplant. One patient had a partial response to first line treatment and was given further rituximab but had progressive disease and was also managed palliatively. One patient had progressive disease and received GDP chemotherapy. 8 patients underwent AlloSCT with BEAM Alemtuzumab conditioning with cyclosporine as GvHD prophylaxis (6 unrelated and 2 sibling donors). The mean overall survival from starting treatment for DHL for the non-transplant cohort was 18.5 months (Range: 0.5 to 36.5) and the median OS was 8.3 months (Range: 4 to 12.6) as compared to mean overall survival of 44.2 months (Range: 22.2 to 66.35) in the transplant cohort with median overall survival not reached (p value: 0.46, Log Rank). In our patients, there was no progression after 3 months from Allo SCT. One patient progressed 6 weeks and died 8 weeks post AlloSCT, whereas two patients progressed 12 weeks and died 14 weeks post AlloSCT. In the cohort who did not undergo AlloSCT, 3 patients have died and two remain in complete remission and 1 patient is undergoing salvage chemotherapy for refractory disease. Conclusion: Our single centre experience of limited number of patients with DHL suggests AlloSCT as a consolidative treatment in first complete remission, may offer survival benefit as compared to no consolidation. Our data also shows no progression of DHL 3 months post AlloSCT highlighting the potential graft versus lymphoma effect. This requires further evaluation in a larger cohort to confirm our preliminary findings and identify potential biomarkers of best response. Confirmation of this result in larger cohort will identify the role of AlloSCT in DHL and enable to reach consensus in the DHL management. Disclosures Kishore: celgene: Other: travel grant.

scholarly journals Bortezomib-Based First Line Treatment for AL Amyloidosis Patients Who Are Not Candidate for Stem Cell Transplantaion

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3256-3256
Author(s):  
Joon Young Hur ◽  
Kang Kook Lee ◽  
Sang Eun Yoon ◽  
Sehhoon Park ◽  
Jangho Cho ◽  
...  
Keyword(s):  
Stem Cell ◽  
Research Funding ◽  
The Body ◽  
Autonomic Nerve ◽  
Al Amyloidosis ◽  
Line Treatment ◽  
Newly Diagnosed ◽  
First Line ◽  
First Line Treatment

Abstract Introduction Systemic AL amyloidosis is characterised by deposition of misfolded immunoglobulin light chains within organs. Treatment for amyloidosis is generally derived from that for multiple myeloma (MM). Combinations of immunomodulatory drugs and proteasome inhibitors are standard frontline MM therapy, but there is little experience with such regimens in AL. For patients not receiving autologous stem cell transplantation (ASCT), bortezomib-based regimens have been first-line treatment in AL amyloidosis over the last few years. The purpose of this study is to investigate the efficacy of bortezomib-based regimens for patients with newly diagnosed AL amyloidosis Methods We performed a retrospective study of all newly diagnosed patients with AL amyloidosis treated at our center between 4/1/11 and 12/31/17. Data pertaining to demographics, diagnosis, treatment and follow-up were extracted from electronic medical records. Survival curves were constructed according to the Kaplan-Meier method and compared using the log rank test. All statistical analyses were performed by using the SPSS 24.0 software. Time to progression (TTP) is defined as time from the date of diagnosis or the start of treatment for a disease until the disease starts to get worse or spread to other parts of the body. The primary endpoint was overall response rate and secondary endpoints were overall survival (OS) and TTP. Results A total 63 patients with newly diagnosed AL amyloidosis who did not receive ASCT were analyzed. Clinical characteristics are shown in Table 1. They included 32 men and 31 women with a median age of 66 years (range, 42-82). Autonomic nerve, Cardiac, peripheral nerve, renal, soft tissue, and liver involvement were found in 46 (73%), 41 (65.1%), 23 (36.5%), 20 (31.7%), 16 (25.4%), 4(6.4%), respectively. The Mayo 2012 stage was: Stage 2 3.8%, Stage 3 30.8% and stage 4 65.4%. Hematological responses were: complete response (CR) 33.3 %, VGPR 19.0%, partial response (PR) 12.6% and no-response (NR) 17.4%. Organ response was 26.9% (n=17). With a median follow-up of 34 months, median OS was 40 months (95% CI 30-50) (Figure 1A) and median TTP was 27 months (95% CI 18-36) (Figure 1B). The rate of early death within 6 months was 28.5% (n=18). Patients were classified according to first-line treatment; bortezomib-based regimens (VMP, n=37; VD (bortezomib and dexamethasone), n=9; VCD, n=8; VMD, n=8; VTD (bortezomib with thalidomide and dexamethasone, n=1). Hematological responses of VMP, VD, VCD, VMD, and VTD were: 75.6%, 55.5%, 50.0%, 50.0%, 100%, respectively. Organ responses of VMP, VD, and VMD were: 35.1%, 22.2%, 25.0%, respectively. Conclusions In this retrospective analysis, bortezomib-based regimens in newly diagnosed AL amyloidosis showed results that appear comparable to those seen at other centers. These findings therefore continue to support the emerging roles for bortezomib-based regimens for the purposes of improving response. Larger scale analyses in multi-center trials would be beneficial to further study these roles. Disclosures Kim: Kyowa-Kirin: Research Funding; Roche: Research Funding; Mundipharma: Research Funding; Novartis: Research Funding; Celltrion: Research Funding; J&J: Research Funding; Takeda: Research Funding.

Long-term follow-up analysis of 100 patients with splenic marginal zone lymphoma treated with splenectomy as first-line treatment

2014 ◽  
Vol 55 (8) ◽  
pp. 1854-1860 ◽  
Author(s):  
Julien Lenglet ◽  
Catherine Traullé ◽  
Nicolas Mounier ◽  
Claire Benet ◽  
Nicolas Munoz-Bongrand ◽  
...  
Keyword(s):  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Splenic Marginal Zone Lymphoma ◽  
Line Treatment ◽  
First Line ◽  
Long Term Follow Up ◽  
First Line Treatment
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