scholarly journals Utility of Routine Post-Therapy Surveillance Imaging in Diffuse Large B-Cell Lymphoma

2014 ◽  
Vol 32 (31) ◽  
pp. 3506-3512 ◽  
Author(s):  
Carrie A. Thompson ◽  
Herve Ghesquieres ◽  
Matthew J. Maurer ◽  
James R. Cerhan ◽  
Pierre Biron ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Clinical Manifestations ◽  
B Cell Lymphoma ◽  
The United States ◽  
Large B Cell Lymphoma ◽  
Surveillance Imaging ◽  
Post Therapy ◽  
Large B Cell

Purpose We examined the utility of post-therapy surveillance imaging in a large, prospectively enrolled cohort of patients with diffuse large B-cell lymphoma (DLBCL) from the United States and confirmed our results in an independent cohort of patients from France. Methods Patients with newly diagnosed DLBCL and treated with anthracycline-based immunochemotherapy were identified from the Molecular Epidemiology Resource (MER) of the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence and the Léon Bérard Cancer Center, Lyon, France. In those with relapse, details at relapse and outcomes were abstracted from records. Results 680 individuals with DLBCL were identified from the MER, 552 (81%) of whom achieved remission after induction. 112 of the 552 patients (20%) suffered a relapse. The majority (64%) of relapses were identified before a scheduled follow-up visit. Surveillance imaging detected DLBCL relapse before clinical manifestations in nine out of 552 patients (1.6%) observed after therapy. In the Lyon cohort, imaging identified asymptomatic DLBCL relapse in four out of 222 patients (1.8%). There was no difference in survival after DLBCL relapse in patients detected at scheduled follow-up versus before scheduled follow-up in both the MER (P = .56) and Lyon cohorts (P = .25). Conclusion The majority of DLBCL relapses are detected outside of planned follow-up, with no difference in outcome in patients with DLBCL detected at a scheduled visit compared with patients with relapse detected outside of planned follow-up. These data do not support the use of routine surveillance imaging for follow-up of DLBCL.

scholarly journals Radiation Exposure As a Link to Primary Ocular Diffuse Large B Cell Lymphoma (PODLBCL) - a Possible Cluster Related to the Chernobyl Explosion

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5381-5381
Author(s):  
Sanford Kempin ◽  
Paul Finger ◽  
John Rescigno ◽  
Jeffrey Rubin ◽  
Walter Choi ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
The United States ◽  
Lymphoid Cells ◽  
High Dose ◽  
Large B Cell Lymphoma ◽  
The Mean ◽  
Large B Cell

Abstract Background: PODLBCL, a rare form of diffuse large B cell lymphoma (DLBCL), arises primarily from the retina and urea. It is estimated to occur in 100 patients/3 years in the United States. Its etiology is unknown although chronic inflammation is thought to play a significant role. It is observed most commonly in immunocompetent patients. EB virus has not been associated with the form of lymphoma. The disease is frequently bilateral (80%) and 56-85% of patients will develop intracerebral metastases. There is a slight male predominance. The peak of incidence is between the fifth and seventh decade. Methods: We have recently had an opportunity to evaluate six patients at the MS/BICCC from 2010-2013. All received initial therapy at MS/BICC. We have analyzed disease presentation, various demographic factors, possible exposure information, treatment and outcome. In addition, epidemiologic studies of the Chernobyl (Ukraine) nuclear power plant explosion (April 26, 1986) were reviewed. The most contaminated regions included Belarus and the Ukraine, with volatile fission products traveling at greater distances (Bard D, Verger P, Hubert P. Chernobyl, 10 Years After: Health Consequences Epidemiologic Reviews 1997:19 (2):187-201). The main health effect continues to be that of thyroid cancers. With respect to ocular findings, liquidators were found to develop senile cataracts, premature myopia and arteriosclerosis of the fundic vessels. The ten-year follow-up demonstrated a slight increase in subcapsular lens changes in children. At the 20 year follow-up (Cardis E, Howe G, Ron E, et al.) Cancer Consequences of the Chernobyl Accident: 20 Years On. J. Radiol Prot 2006; 26:127-140) there has been no conclusive reported increase in childhood or adult leukemia of lymphoma. In the most recent update (Pflugbeil S, Claussen A, Schmitz-Feuerhake. Health Effects of Chernobyl 25 Years After the Reactor Catastrophe. 2011: Gesellschaft fur Strahlenschutz) there is still no definitive evidence of an increase in lymphoma. Results: In our series the most common complaint was cloudiness of vision and the most common findings were anterior chamber inflammation, sheets of cells within the vitreous, uveitis and subretinal and retinal infiltrates. The presentation was bilateral in all patients. The mean age at presentation was 76 years (62-84), including five women and one man (the female predominance is unusual). At the time of exposure, four of the patients were living in the Ukraine; one in Moldova and one is southern Poland. The mean time possible exposure to appearance of PODLBCL was 26 years. The diagnosis was made by vitreous FNA (2), vitreous biopsy (4), clinical presentation (1). Initial treatments included chemotherapy (high dose methotrexate) in two patients, and radiation therapy in four patients. Of the six there was one synchronous presentation with brain lymphoma. Two patients developed spread to the brain, one of whom expired and one of whom is considered NED after whole brain irradiation and temazolomide. Five patients remain NED, but at short follow-up. Conclusions: Conceptionally, lymphomas are thought to develop because of an inherent sensitivity of lymphoid cells to genetic instability, immune stimulation, inherited genetic disorders, toxins, infections agents as well as radiation injury. For almost all etiologies it is accepted that a long prodromal period between exposure and subsequent appearance of neoplasia occurs and these case reports may be an illustration of this phenomena. It is estimated that several million Europeans were exposed to radiation as a result of this explosion. As the ocular globe would appear to be one of the most exposed organs, more patients with this unusual malignancy may be seen and an appreciation of this possibility would seem warranted. Disclosures No relevant conflicts of interest to declare.

scholarly journals Surveillance Imaging in Patients with Diffuse Large B-Cell Lymphoma

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4883-4883
Author(s):  
Ayako Matsumura ◽  
Hideyuki Kuwabara ◽  
Kumiko Kishimoto ◽  
Eriko Fujii ◽  
Kazuho Miyashita ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Symptoms ◽  
Cell Lymphoma ◽  
Clinical Stage ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Surveillance Imaging ◽  
Large B Cell ◽  
Chop Therapy

Abstract Background: Approximately 80% of patients with diffuse large B-cell lymphoma (DLBCL) achieve a complete response (CR) after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy (R-CHOP) as first-line treatment but approximately 25% of patients with CR experience relapse. Disease recurrence generally occurs in the first 2 years following the first CR, but some patients relapse in the 5 years following the first CR. The optimal follow-up strategy for patients with non-Hodgkin's lymphoma has been under consideration. There are limitations to surveillance imaging, including risk of increase in healthcare costs, and increased anxiety due to the possibility of recurrence. To assess the role of surveillance imaging in the rituximab era, we retrospectively analyzed DLBCL patients, treated with a uniform treatment regimen, who relapsed after achieving the first CR. Patients and Methods : Between 2004 and 2009, DLBCL patients were newly diagnosed and were treated with 6 to 8 cycles of full-dose R-CHOP therapy (50 mg/m2 doxorubicin, 750 mg/m2 cyclophosphamide and 1.4 mg/m2 [maximum 2.0 mg/body] vincristine on day 1, 100 mg/body per day of prednisolone on days 1 to 5, and 375 mg/m2 rituximab per treatment cycle; treatment cycles were repeated every 3 weeks) at the 8 institutions of the Yokohama City University Hematology Group. Physical examinations were performed every 1 to 3 months, and periodical CT was generally performed every 6 months for 5 years after achieving CR. The relapses were categorized into 2 groups based on the modality of detection. One group consisted of the relapses that were detected by surveillance imaging (SI) in the absence of symptoms. The other group was composed of relapses that were detected by clinical symptoms, abnormal laboratory data, or SI in the presence of symptoms. Overall survival (OS) was measured from the start of the initial treatment until the time of the last follow-up or death. Using Kaplan-Meier survival analysis and the log-rank test, we assessed OS based on the modality of relapse detection. Result s: In total, 315 patients with DLBCL were diagnosed and treated with R-CHOP therapy. Further, 289 patients achieved the first CR. We identified 52 patients who relapsed after the first CR. The patients who relapsed were at a more progressed clinical stage and had a higher International Prognostic Index (IPI) score than the patients in CR, although there were no significant differences in the age, gender, or median duration of follow-up between the patients with or without CR. Of the 52 relapsed patients, 19 relapses (37%) were detected by routine SI in the absence of clinical symptoms. The remaining 33 relapses (63%) were detected by SI in the presence of clinical symptoms (CS) or were detected following unscheduled imaging due to the presence of clinical symptoms or abnormal laboratory findings. The most frequently observed clinical symptom in the CS group was lymphadenopathy (n = 13, 39%). Median observation period after the first relapse in the 24 survivors (10 in SI group and 14 in CS group) was 62 months. There were no significant differences in age, gender, clinical stage, IPI, or median relapse-free duration between the SI and CS groups. The OS curve is shown in Figure below. There was no significant difference (P = 0.23) in the 5-year OS rates in the SI and the CS groups. Conclusion: Periodic surveillance imaging does not prolong the OS in relapsed patients. There are more to be discussed about the follow up strategy for DLBCL. Disclosures No relevant conflicts of interest to declare.

scholarly journals Molecular Sub-typing of Diffuse Large B-cell Lymphoma

2021 ◽  
Author(s):  
Thomas Drago
Keyword(s):  
B Cell ◽  
Germinal Center ◽  
Cell Lymphoma ◽  
Rapid Development ◽  
B Cell Lymphoma ◽  
The United States ◽  
Cellular Level ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) is the most common form of Non-Hodgkin Lymphoma (NHL) in adults. Affecting nearly 7 out of every 100,000 people in the United States annually, this hematogenous neoplasm is known for its aggressiveness and rapid development. Being the most common NHL, it has been divided into several subgroups based on pathogenesis and treatment methods. In particular, subtypes such as germinal center, activated B-cell-like, and primary mediastinal diffuse large B-cell lymphomas  have been divided by their uniqueness of pathology at the cellular level. Knowing the numerous cytokines, inflammatory markers, and other microcellular processes that these lymphomas disrupt can help target an effective therapeutic at the disease.

scholarly journals C-MYC Protein Expression and High Ki-67 Proliferative Index are Predictives of Disease Relapse in Diffuse Large B Cell Lymphoma

2021 ◽  
Vol 6 (1) ◽  
pp. 15-20
Author(s):  
Mahmoud Tag El-Hussien ◽  
Nadia Mokhtar ◽  
Eman Naguib Khorshed
Keyword(s):  
Protein Expression ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Statistical Prediction ◽  
Proliferative Index ◽  
Ki 67 ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Objective: To evaluate the status of C-MYC protein expression and Ki-67 proliferative index and to clarify their role in predicting relapse of diffuse large B cell lymphoma (DLBL). Materials and Methods: A retrospective study conducted on 50 cases diagnosed as DLBL in a 3 years’ time period from January 2014 till December 2016, collected from the archive of Pathology Departments of the National Cancer Institute Cairo - Egypt, Misr University for Science and Technology and private labs of authors. The diagnosis of DLBL for all cases, both nodal and extranodal, was confirmed by histopathologic examination and immunophenotyping. Automated immunohistochemical staining using antibodies against C-MYC protein and MIB-1 was used to evaluate the C-MYC expression in tumor cells and to assess their proliferative ability by calculating Ki-67 labelling index. The relation between the percentage of C-MYC protein expression, Ki-67 proliferative index, clinical data and the relapse status during the follow up period were analyzed. Results: A total of 50 cases of DLBL in both nodal and extra-nodal sites were included. Twenty-three cases (46%) were expressing the C-MYC protein, and 29 cases (58%) showed high Ki-67 proliferative index. Twenty-two cases (44%) relapsed during the follow-up period. Positive C-MYC protein expression was significantly associated with high Ki-67 proliferative index. C-MYC protein expression and high Ki-67 proliferative index were independently associated with disease relapses in 81.8% and 86.4% of cases respectively. Cases with combined C-MYC protein expression and high Ki-67 proliferative index showed statistical prediction of relapse in 81.8% of cases. Conclusion: C-MYC protein expression and high Ki-67 proliferative index were independently associated with relapse of diffuse large B cell lymphoma. Furthermore, the combined positive C-MYC protein expression and high Ki-67 proliferative index is better than a single positive test in predicting relapses among DLBL patients.

scholarly journals Single Centre Retrospective Analysis: Transformation of Waldenström's Macroglobulinemia to Diffuse Large B-Cell Lymphoma

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 11-11
Author(s):  
Bert Heyrman ◽  
Nikki Granacher ◽  
Ka Lung Wu
Keyword(s):  
B Cell ◽  
Retrospective Analysis ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Single Centre ◽  
The Past ◽  
Large B Cell Lymphoma ◽  
End Of Treatment ◽  
Large B Cell

Introduction: The incidence and outcome of Waldenström's macroglobulinemia (WM) patients with transformation to diffuse large B-cell lymphoma (DLBCL) are unclear. We performed a retrospective analysis to determine the incidence, clinicopathological characteristics and treatment outcome of WM patient with histologic transformation to DLBCL in our centre. Methods: Single centre chart review of WM patients in the past 10 years. Patients with histologic diagnosis of DLBCL after the diagnosis WM were included in our analysis. Results: Three of the 79 WM patients had histological transformation to DLBCL, two male and one female. Mean age at DLBCL development was 76,6 years. The mean time to transformation since diagnosis of WM was 8,3 years (14, 8 and 3 years). All three patients received at least one prior line of treatment in relation to WM (2, 1 and 3 prior lines). Different regimens used were cyclophosphamide/dexamethasone, rituximab/bendamustin, chlorambucil monotherapy, fludarabine monotherapy, R-CVP and ibrutinib monotherapy. The patients were in clinical CR from WM at the time of transformation, two patients were still on treatment. All three patients presented with advanced disease (stage IIIB, IVB, and IVA) non-GCB subtype DLBCL with at least 2 extra nodal sites. R-IPI scores were 4,5 and 4. Two patients were treated with R-miniCHOP, one patient received R-CHOP. The first patient achieved a CR at the end of treatment and is now 1,5 years in follow-up. The second patient died from pneumonia one year after achieving a CR. The third patient is in follow op since 3 months after reaching a CR at the end of treatment. Conclusion: Over the past decade transformation of WM to DLBCL was 3.7% in our centre. This is in accordance with previous data suggesting an 2.4% risk of transformation over 10 years.Time to transformation varies and no association with prior WM therapy and response to treatment can be found.All patients presented with more aggressive DLBCL in an advanced stage.All three patients achieved a CR following treatment for DLBCL, one patient died from pneumonia, two others are now in follow-up 1,5 years and 3 months respectively. Disclosures Heyrman: Celgene:Research Funding.

scholarly journals Systematic Literature Review of the Clinical Evidence in Relapsed/Refractory (R/R) Large B-Cell Lymphoma

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5821-5821
Author(s):  
David G. Maloney ◽  
Fei Fei Liu ◽  
Lisette Nientker ◽  
Cathelijne Alleman ◽  
Brian Hutton ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
T Cell Therapy ◽  
Car T Cell ◽  
Large B Cell Lymphoma ◽  
Car T ◽  
Large B Cell

Introduction: Large B-cell lymphoma (LBCL) is the most common subtype of non-Hodgkin lymphoma. Frontline treatment is curative in ~60% of patients (pts); however, ~30% of pts relapse and ~10% are refractory to frontline treatment. Treatment options for pts with relapsed/refractory (R/R) disease, especially in the third-line or greater (3L+) setting, have been primarily salvage chemotherapies (CTs). Recently, 2 CAR T cell products, axicabtagene ciloleucel (Yescarta®) and tisagenlecleucel (Kymriah®), and the antibody-drug conjugate, polatuzumab vedotin (Polivy®), were approved in the 3L setting. A systematic literature review (SLR) of R/R LBCL was conducted to identify relevant evidence on clinical outcomes in LBCL pts, including these new therapies, within the second-line and greater (2L+) or 3L+ setting, and to define the unmet medical need. Methods: This SLR was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and European Union Health Technology Assessment requirements. The review identified randomized and nonrandomized/observational studies within R/R LBCL, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma grade 3B (FL3B), primary mediastinal large B-cell lymphoma (PMBCL), DLBCL transformed from indolent lymphomas, and R/R DLBCL with secondary central nervous system (SCNS) involvement. Sources were EMBASE, MEDLINE, The Cochrane Library, and clinical conferences (ASCO, ESMO, EHA, ASH, ICML, AACR, and EORTC) from Jan 2000 to Apr 2019. Results : Following screening of 8683 database records and additional sources, 103 publications covering 78 unique studies were identified. Studies identified were characterized by line of treatment and R/R LBCL subtype (Figure). OS, PFS, DOR, OR, and safety observed from the identified studies were described. Disease subtypes, pt eligibility criteria, and length of follow-up varied notably across studies. In the 3L+ population, 11 salvage CT and 2 CAR T cell therapy studies reported survival outcomes. With salvage CT, the reported ORR across studies ranged from 0% to 54%, while CR ranged from 5.6%-31%. Median OS (mOS) ranged between 3-9 months, with one outlying study reporting mOS at 20 months. Median PFS (mPFS) reported within the salvage CT studies ranged from 2-6 months. Among CAR T cell therapies, pts treated with axicabtagene ciloleucel (n=101) reported a CR rate of 58% and median DOR (mDOR) was 11.1 months after a median follow-up of 27.1 months. mPFS was 5.9 months and mOS was not reached. At a median follow-up of 19.3 months, pts treated with tisagenlecleucel (n=115) had a CR of 40% but the mDOR was not reached. mOS was 11.1 months for all infused patients. In the 2L+ transplant-eligible population (36 studies), pts who received high-dose CT + HSCT achieved mOS between 9 months to 5 years. In the transplant noneligible population, 16 studies reported mOS between 3-20 months. Studies involving mixed transplant-eligible and noneligible populations (30 studies) reported mOS of 1-17 months. A few studies with limited sample sizes were found to report outcomes in LBCL subtypes (eg, PMBCL, SCNS lymphoma, DLBCL transformed from non-FL indolent lymphoma, FL3B). In the 3L+ setting, 1 study reported that mOS was not reached after a median of 6.6 months. In the 2L+ setting, 4 studies reported mPFS and mOS outcomes ranging between 2-9 months and 10-16 months, respectively. Among studies assessing safety of salvage CTs in R/R LBCL, neutropenia, leukocytopenia, thrombocytopenia, and infections were the most commonly reported adverse events (AEs), with neutropenia being the most reported. Among the 3 studies reporting safety outcomes of CAR T cell therapy, data suggest that hematologic AEs (possibly related to lymphodepleting CT), cytokine release syndrome, and neurotoxicity are the most reported. Conclusions : Despite the availability of new therapies for 2L+ and 3L + LBCL, examination of the current evidence has shown that there exists a high unmet need for additional therapeutic options that provide favorable benefit/risk and durable response for these patients. Furthermore, limited data are available for the rarer subtypes of LBCL. Both findings represent important treatment gaps for R/R LBCL that must be addressed in future research geared toward improvement of the current treatment landscape. Disclosures Maloney: Juno Therapeutics: Honoraria, Patents & Royalties: patients pending , Research Funding; Celgene,Kite Pharma: Honoraria, Research Funding; BioLine RX, Gilead,Genentech,Novartis: Honoraria; A2 Biotherapeutics: Honoraria, Other: Stock options . Liu:Celgene Corporation: Employment. Nientker:Celgene Corporation: Consultancy; Pharmerit Cöoperatief U.A.: Employment. Alleman:Pharmerit Cöoperatief U.A.: Employment; Celgene Corporation: Consultancy. Garcia:Celgene: Employment, Equity Ownership.

Long-Term Follow-Up of a Phase II Trial of Six Cycles of Dose-Dense R-CHOP-14 for First-Line Treatment of Diffuse Large B-Cell Lymphoma in Young and Elderly Patients

2016 ◽  
Vol 136 (2) ◽  
pp. 76-84 ◽  
Author(s):  
Eva González-Barca ◽  
Miguel A. Canales ◽  
Antonio Salar ◽  
Secundino Ferrer ◽  
Eva Domingo-Domenech ◽  
...  
Keyword(s):  
Survival Rate ◽  
Elderly Patients ◽  
B Cell ◽  
Phase Ii ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Background/Aims: Rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 14 days seems to achieve better outcomes than R-CHOP every 21 days in diffuse large B-cell lymphoma (DLBCL) patients. Currently, the standard regimen is R-CHOP every 21 days. Methods: This is a phase II clinical trial of treatment with 6 cycles of R-CHOP-14 with pegfilgrastim support in 2 populations of previously untreated DLBCL patients aged ≥65 years (n = 73) or <65 years (n = 51) with low-risk International Prognostic Index scores (0-2). Results: With a median follow-up of 63.7 months, the 5-year event-free survival rate was 53.8% in patients aged ≥65 years and 71.0% in patients aged <65 years. The 5-year overall survival rate was 71.4 and 89.8%, respectively. The complete remission rate was 69.9% for older and 80.4% for younger patients. The median relative dose intensity of cytotoxic drugs was 143.2% in the elderly and 149.1% in the young patients. Febrile neutropenia was the most common grade 3-4 adverse event, being higher in elderly patients (21.3 vs. 9.3%). Eight deaths (7 in elderly patients) were considered treatment related. Conclusion: In conclusion, the R-CHOP-14 regimen is feasible and very active, though it is more toxic in elderly patients mainly due to an increased incidence of infections. New strategies, such as new monoclonal antibodies or new targeted therapies, are needed to improve the outcomes of DLBCL patients.

A case of primary breast diffuse large B cell lymphoma

2021 ◽  
Vol 148 (12) ◽  
pp. 102-107
Author(s):  
Trinh Le Huy ◽  
Tran Dinh Anh
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Painless Mass ◽  
Large B Cell

Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin’s lymphoma with limited data. We here report a case of primary breast diffuse large B-cell lymphoma mimicking breast cancer. A 52-year-old woman had a painless mass in her right breast. Fine needle aspiration cytology and core biopsy were performed which suggested malignant features but could not confirm the specific subtype. Excisional biopsy then was conducted revealing non-Hodgkin lymphoma, which was subsequently confirmed with histopathology and diagnosed as diffuse large B-cell lymphoma (DLBCL). A chest computed tomography scan revealed a 3.5 cm sized breast mass with skin thickening and modest lymphadenopathy in the ipsilateral axilla. The patient received six courses of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone plus rituximab) chemotherapy, then whole breast radiation (30Gy in 15 fractions). At 12 months of follow-up, the patient survives with no evidence of disease. No morbidities occurred in this patient during the follow-up period. We briefly review the current practice pattern in patients with primary breast diffuse large B-cell lymphoma.

scholarly journals High metabolic tumor volume is associated with decreased efficacy of axicabtagene ciloleucel in large B-cell lymphoma

2020 ◽  
Vol 4 (14) ◽  
pp. 3268-3276 ◽  
Author(s):  
Erin A. Dean ◽  
Rahul S. Mhaskar ◽  
Hong Lu ◽  
Mina S. Mousa ◽  
Gabriel S. Krivenko ◽  
...  
Keyword(s):  
B Cell ◽  
Tumor Volume ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Metabolic Tumor Volume ◽  
Primary Objective ◽  
T Cell Therapy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract High metabolic tumor volume (MTV) predicts worse outcomes in lymphoma treated with chemotherapy. However, it is unknown if this holds for patients treated with axicabtagene ciloleucel (axi-cel), an anti-CD19 targeted chimeric antigen receptor T-cell therapy. The primary objective of this retrospective study was to investigate the relationship between MTV and survival (overall survival [OS] and progression-free survival [PFS]) in patients with relapsed/refractory large B-cell lymphoma (LBCL) treated with axi-cel. Secondary objectives included finding the association of MTV with response rates and toxicity. The MTV values on baseline positron emission tomography of 96 patients were calculated via manual methodology using commercial software. Based on a median MTV cutoff value of 147.5 mL in the first cohort (n = 48), patients were divided into high and low MTV groups. Median follow-up for survivors was 24.98 months (range, 10.59-51.02 months). Patients with low MTV had significantly superior OS (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.10-0.66) and PFS (HR, 0.40; 95% CI, 0.18-0.89). Results were successfully validated in a second cohort of 48 patients with a median follow-up for survivors of 12.03 months (range, 0.89-25.74 months). Patients with low MTV were found to have superior OS (HR, 0.14; 95% CI, 0.05-0.42) and PFS (HR, 0.29; 95% CI, 0.12-0.69). In conclusion, baseline MTV is associated with OS and PFS in axi-cel recipients with LBCL.

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