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Ladetto M, Tavarozzi R, Zanni M, Evangelista A, Ferrero S, Tucci A, Botto B, Bolis S, Volpetti S, Zilioli VR, Puccini B, Arcari A, Pavone V, Gaidano G, Corradini P, Tani M, Cavallo F, Milone G, Ghiggi C, Pinto A, Pastore D, Ferreri AJM, Latte G, Patti C, Re F, Benedetti F, Luminari S, Pennese E, Bossi E, Boccomini C, Anastasia A, Bottelli C, Ciccone G, Vitolo U. Radioimmunotherapy versus autologous hematopoietic stem cell transplantation in relapsed/refractory follicular lymphoma: a Fondazione Italiana Linfomi multicenter, randomized, phase III trial. Ann Oncol 2024; 35:118-129. [PMID: 37922989 DOI: 10.1016/j.annonc.2023.10.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/11/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Optimal consolidation for young patilents with relapsed/refractory (R/R) follicular lymphoma (FL) remains uncertain in the rituximab era, with an unclear benefit of autologous stem cell transplantation (ASCT). The multicenter, randomized, phase III FLAZ12 (NCT01827605) trial compared anti-CD20 radioimmunotherapy (RIT) with ASCT as consolidation after chemoimmunotherapy, both followed by rituximab maintenance. PATIENTS AND METHODS Patients (age 18-65 years) with R/R FL and without significant comorbidities were enrolled and treated with three courses of conventional, investigator-chosen chemoimmunotherapies. Those experiencing at least a partial response were randomized 1 : 1 to ASCT or RIT before CD34+ collection, and all received postconsolidation rituximab maintenance. Progression-free survival (PFS) was the primary endpoint. The target sample size was 210 (105/group). RESULTS Between August 2012 and September 2019, of 164 screened patients, 159 were enrolled [median age 57 (interquartile range 49-62) years, 55% male, 57% stage IV, 20% bulky disease]. The study was closed prematurely because of low accrual. Data were analyzed on 8 June 2023, on an intention-to-treat basis, with a 77-month median follow-up from enrollment. Of the 141 patients (89%), 70 were randomized to ASCT and 71 to RIT. The estimated 3-year PFS in both groups was 62% (hazard ratio 1.11, 95% confidence interval 0.69-1.80, P = 0.6662). The 3-year overall survival also was similar between the two groups. Rates of grade ≥3 hematological toxicity were 94% with ASCT versus 46% with RIT (P < 0.001), and grade ≥3 neutropenia occurred in 94% versus 41%, respectively (P < 0.001). Second cancers occurred in nine patients after ASCT and three after radioimmunotherapy (P = 0.189). CONCLUSIONS Even if prematurely discontinued, our study did not demonstrate the superiority of ASCT versus RIT. ASCT was more toxic and demanding for patients and health services. Both strategies yielded similar, favorable long-term outcomes, suggesting that consolidation programs milder than ASCT require further investigation in R/R FL.
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Affiliation(s)
- M Ladetto
- Department of Translational Medicine, University of Eastern Piedmont, Novara; SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria.
| | - R Tavarozzi
- Department of Translational Medicine, University of Eastern Piedmont, Novara; SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | - M Zanni
- SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | - A Evangelista
- SSD of Clinical Epidemiology, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - S Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - A Tucci
- Department of Hematology, Spedali Civili, Brescia
| | - B Botto
- Struttura Complessa Ematologia, AOU Città della salute e della scienza di Torino, Turin
| | - S Bolis
- SC Ematologia ASST-Monza, Monza
| | - S Volpetti
- Division of Hematology, Clinica Ematologica, Centro Trapianti e Terapie Cellulari Carlo Melzi, DISM, Azienda Ospedaliero Universitaria S. M. Misericordia, Udine
| | - V R Zilioli
- Division of Haematology, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - B Puccini
- Department of Haematology, University of Florence, Firenze
| | - A Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza
| | - V Pavone
- A. O. C. Panico-U.O.C Ematologia e Trapianto, Tricase, Lecce
| | - G Gaidano
- SCDU di Ematologia, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria; Division of Hematology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara
| | - P Corradini
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milan, Milano
| | - M Tani
- Hematology Unit, Department of Oncology and Hematology, "Santa Maria delle Croci" Hospital, Ravenna
| | - F Cavallo
- Department of Molecular Biotechnologies and Health Sciences, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - G Milone
- Division of Hematology and Program for Hematopoietic Transplantation, Azienda Ospedaliera Policlinico Vittorio Emanuele, Catania
| | - C Ghiggi
- Hematology Division, IRCCS Azienda Ospedaliera Universitaria San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genova
| | - A Pinto
- Department of Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico "Fondazione G Pascale", Naples
| | | | - A J M Ferreri
- Onco-Hematology Department, Fondazione Centro San Raffaele, Milano
| | - G Latte
- Unità di Ematologia e Trapianto di Midollo Osseo, San Francesco Hospital, Nuoro
| | - C Patti
- Divisione di Oncoematologia, Azienda Villa Sofia - Cervello, Palermo
| | - F Re
- Department of Hematology, A.O.U. di Parma, Parma
| | - F Benedetti
- Department of Medicine, Section of Hematology and Bone Marrow Transplant Unit, University of Verona, Verona
| | - S Luminari
- Department of Hematology, IRCCS Reggio Emilia, Reggio Emilia
| | - E Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara
| | - E Bossi
- SC Ematologia ASST-Monza, Monza
| | - C Boccomini
- Struttura Complessa Ematologia, AOU Città della salute e della scienza di Torino, Turin
| | - A Anastasia
- Department of Hematology, Spedali Civili, Brescia
| | - C Bottelli
- Department of Hematology, Spedali Civili, Brescia
| | - G Ciccone
- SSD of Clinical Epidemiology, Universitaria Città della Salute e della Scienza di Torino and Centre for Cancer Prevention Piemonte, Torino
| | - U Vitolo
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
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Chiappella A, Carniti C, Re A, Castellino C, Evangelista A, Ciancia R, Orsucci L, Pinto A, Usai SV, Arcari A, Ilariucci F, Rossi FG, Benedetti F, Flenghi L, Ghiggi C, Molinari AL, Stefoni V, Volpetti S, Zilioli VR, Ballerini F, Bruna R, Cavallo F, Musuraca G, Patti C, Re F, Tani M, Varettoni M, Zanni M, Dodero A, Pileri SA, Ciccone G, Corradini P. ROMIDEPSIN‐CHOEP PLUS UP‐FRONT STEM‐CELL TRANSPLANTATION IN PERIPHERAL T‐CELL LYMPHOMA (PTCL): FIRST ANALYSIS OF THE PHASE II FIL‐PTCL13 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.130_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A. Chiappella
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - C. Carniti
- Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano Laboratory of Hematology Division of Hematology and Stem Cell Transplantation Milano Italy
| | - A. Re
- ASST Spedali Civili di Brescia Hematology Division Brescia Italy
| | - C. Castellino
- Azienda Ospedaliera S. Croce e Carle Division of Hematology Cuneo Italy
| | - A. Evangelista
- Azienda Ospedaliera e Universitaria Città della Salute e della Scienza and CPO Piemonte Unit of Clinical Epidemiology Torino Italy
| | - R. Ciancia
- Centro di Riferimento Oncologico (CRO) IRCCS Onco‐hematology and Stem Cell Transplantation and Cellular Therapies Aviano Italy
| | - L. Orsucci
- Azienda Ospedaliera e Universitaria Città della Salute e della Scienza Division of Hematology Torino Italy
| | - A. Pinto
- Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS Hematology‐Oncology & Stem Cell Transplantation Unit Napoli Italy
| | - S. V. Usai
- Ospedale Oncologico Armando Businco Hematology Cagliari Italy
| | - A. Arcari
- Ospedale Guglielmo da Saliceto Hematology Unit Piacenza Italy
| | - F. Ilariucci
- Azienda USL‐IRCCS, Hematology Reggio Emilia Italy
| | - F. G. Rossi
- Fondazione IRCCS Cà Granda OM Policlinico Division of Hematology Milano Italy
| | - F. Benedetti
- Azienda Ospedaliera Universitaria di Verona Hematology and Stem Cell Transplantation Verona Italy
| | - L. Flenghi
- Azienda Ospedaliera di Perugia Hematology Perugia Italy
| | - C. Ghiggi
- IRCCS Ospedale Policlinico San Martino Hematology Genova Italy
| | | | - V. Stefoni
- University of Bologna Institute of Hematology "Seràgnoli" Bologna Italy
| | - S. Volpetti
- Presidio Ospedaliero Universitario "Santa Maria della Misericordia” di Udine ASUFC Clinic of Hematology Udine Italy
| | - V. R. Zilioli
- ASST Grande Ospedale Metropolitano Niguarda Division of Hematology Milano Italy
| | - F. Ballerini
- IRCCS Ospedale Policlinico San Martino Clinic of Hematology Genova Italy
| | - R. Bruna
- Ospedale Maggiore Della Carità Division of Hematology Novara Italy
| | - F. Cavallo
- University of Torino Azienda Ospedaliera e Universitaria Città della Salute e della Scienza Division of Hematology Department of Molecular Biotechnologies and Health Sciences Torino Italy
| | - G. Musuraca
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" Division of Hematology Meldola Italy
| | - C. Patti
- Azienda Villa Sofia Cervello Division of Onco‐Hematology Palermo Italy
| | - F. Re
- Azienda Ospedaliera‐Universitaria di Parma Hematology and CTMO Parma Italy
| | - M. Tani
- Ospedale Santa Maria delle Croci Hematology Unit Ravenna Italy
| | - M. Varettoni
- Fondazione IRCCS Policlinico San Matteo Division of Hematology Pavia Italy
| | - M. Zanni
- Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo Division of Hematology Alessandria Italy
| | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - S. A. Pileri
- European Institute of Oncology IRCCS Division of Haematopathology Milano Italy
| | - G. Ciccone
- Azienda Ospedaliera e Universitaria Città della Salute e della Scienza and CPO Piemonte Unit of Clinical Epidemiology Torino Italy
| | - P. Corradini
- Chair of Hematology University of Milano Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology and Stem Cell Transplantation Milano Italy
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Chiappella A, Carniti C, Evangelista A, Re A, Cabras M, Stefoni V, Castellino C, Congiu A, Pinto A, Zanni M, Rusconi C, Molinari A, Ciancia R, Baldini L, Nassi L, Re F, Tani M, Ilariucci F, Cavallo F, Santoro A, Volpetti S, Dodero A, Pileri S, Ciccone G, Corradini P. PHASE II FIL-PTCL13 STUDY OF ROMIDEPSIN-CHOEP FOLLOWED BY HIGH-DOSE CHEMOTHERAPY AND TRANSPLANTATION IN UNTREATED PERIPHERAL T-CELL LYMPHOMAS. Hematol Oncol 2019. [DOI: 10.1002/hon.3_2632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A. Chiappella
- Ematologia; AOU Città della Salute e della Scienza di Torino; Torino Italy
| | - C. Carniti
- Ematologia; Università degli Studi di Milano; Milano Italy
| | - A. Evangelista
- SSD Epidemiologia Clinica e Valutativa; Clinical Trial Center, AOU Città della Salute e della Scienza di Torino e CPO Piemonte; Torino Italy
| | - A. Re
- Ematologia; ASTT Spedali Civili di Brescia; Brescia Italy
| | - M.G. Cabras
- Ematologia; Ospedale Oncologico Armando Businco; Cagliari Italy
| | - V. Stefoni
- Ematologia; Policlinico S.Orsola-Malpighi, Istituto di Ematologia "Seragnoli"; Bologna Italy
| | - C. Castellino
- Ematologia e Trapianto di Midollo Osseo; AO Santa Croce e Carle; Cuneo Italy
| | - A.G. Congiu
- Ematologia; Ospedale Policlinico San Martino S.S.R.L. - IRCCS per l'Oncologia; Genova Italy
| | - A. Pinto
- Ematologia Oncologica; Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale; Napoli Italy
| | - M. Zanni
- Ematologia; AO SS Antonio e Biagio e Cesare Arrigo; Alessandria Italy
| | - C. Rusconi
- Ematologia; ASST Grande Ospedale Metropolitano Niguarda; Milano Italy
| | | | - R. Ciancia
- Oncoematologia; trapianti emopoietici e terapie cellulari, Centro di Riferimento Oncologico CRO, IRCCS; Aviano Italy
| | - L. Baldini
- Ematologia; Ospedale Maggiore Policlinico - Fondazione IRCCS Ca' Granda; Milano Italy
| | - L. Nassi
- Ematologia; AOU Maggiore della Carità di Novara; Novara Italy
| | - F. Re
- Ematologia e CTMO; AOU Ospedale Maggiore di Parma; Parma Italy
| | - M. Tani
- Ematologia; Ospedale Santa Maria delle Croci; Ravenna Italy
| | - F. Ilariucci
- Ematologia; Azienda Ospedaliera Arcispedale Santa Maria Nuova - IRCCS; Reggio Emilia Italy
| | - F. Cavallo
- Ematologia; Università degli Studi - AOU Città della Salute e della Scienza di Torino; Torino Italy
| | - A. Santoro
- Ematologia; Istituto Clinico Humanitas; Rozzano Italy
| | - S. Volpetti
- Ematologia; ASUI Santa Maria della Misericordia; Udine Italy
| | - A. Dodero
- Ematologia; Fondazione IRCCS Istituto Nazionale dei Tumori; Milano Italy
| | - S.A. Pileri
- Emopatologia; Istituto Europeo Oncologico IRCCS; Milano Italy
| | - G. Ciccone
- SSD Epidemiologia Clinica e Valutativa; Clinical Trial Center, AOU Città della Salute e della Scienza di Torino e CPO Piemonte; Torino Italy
| | - P. Corradini
- Ematologia; Fondazione IRCCS Istituto Nazionale dei Tumori - Università degli Studi di Milano; Milano Italy
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Ferreri A, Sassone M, Angelillo P, Zaja F, Re A, Spina M, Di Rocco A, Fabbri A, Stelitano C, Frezzato M, Rusconi C, Zambello R, Arcari A, Bertoldero G, De Lorenzo D, Volpetti S, Calimeri T, Perrone S, Cecchetti C, Ciceri F, Ponzoni M. LONG-TERM EFFICACY AND SAFETY OF LENALIDOMIDE MAINTENANCE IN PATIENTS WITH RELAPSED DIFFUSE LARGE B-CELL LYMPHOMA WHO ARE NOT ELIGIBLE FOR AUTOLOGOUS TRANSPLANTATION (ASCT). Hematol Oncol 2019. [DOI: 10.1002/hon.65_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A.J. Ferreri
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - M.C. Sassone
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - P. Angelillo
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - F. Zaja
- SC Ematologia; Azienda Sanitaria Universitaria Integrata; Trieste Italy
| | - A. Re
- Division of Hematology; Spedali Civili; Brescia Italy
| | - M. Spina
- Oncologia; Centro di Riferimento Oncologico; Aviano Italy
| | - A. Di Rocco
- Division of Hematology; University ”La Sapienza”; Rome Italy
| | - A. Fabbri
- Division of Hematology; Azienda Ospedaliera Università Senese; Siena Italy
| | - C. Stelitano
- Division of Hematology; Azienda Ospedaliera Bianchi-Melacrino-Morelli; Reggio Calabria Italy
| | - M. Frezzato
- Division of Hematology; San Bortolo Hospital; Vicenza Italy
| | - C. Rusconi
- Division of Hematology; Niguarda Hospital; Milan Italy
| | - R. Zambello
- Division of Hematology; Azienda Ospedaliera di Padua; Padua Italy
| | - A. Arcari
- Department of Oncology and Hematology; Guglielmo da Saliceto Hospital; Piacenza Italy
| | - G. Bertoldero
- U.O. di Oncologia ed Ematologia Oncologica; Ospedale di Mirano; Mirano Italy
| | - D. De Lorenzo
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - S. Volpetti
- Clinica Ematologia; Azienda Sanitaria Universitaria Integrata, DAME; Udine Italy
| | - T. Calimeri
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - S. Perrone
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - C. Cecchetti
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - F. Ciceri
- Onco-Hematology; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - M. Ponzoni
- Pathology; IRCCS San Raffaele Scientific Institute; Milan Italy
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Pellegrini C, Pulsoni A, Rigacci L, Patti C, Gini G, Tani M, Rusconi C, Romano A, Vanazzi A, Hohaus S, Mazza P, Molica S, Corradini P, Gaudio F, Ronconi F, Pinto A, Pavone V, Volpetti S, Visentin A, Bonfichi M, Schiavotto C, Spina M, Carella A, Argnani L, Zinzani P. REAL LIFE EXPERIENCE WITH BRENTUXIMAB VEDOTIN: THE ITALIAN STUDY ON 234 RELAPSED/REFRACTORY HODGKIN'S LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C. Pellegrini
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
| | - A. Pulsoni
- Hematology, Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - L. Rigacci
- Hematology Department; University and Hospital Careggi; Florence Italy
| | - C. Patti
- Hematology; Azienda Ospedali Riuniti Villa Sofia Cervello; Palermo Italy
| | - G. Gini
- Hematology; Ospedali Riuniti; Ancona Italy
| | - M. Tani
- Hematology; Santa Maria delle Croci Hospital; Ravenna Italy
| | - C. Rusconi
- Division of Hematology Niguarda Cancer Center; Niguarda Hospital; Milan Italy
| | - A. Romano
- Hematology, Azienda Policlinico-OVE; University of Catania; Catania Italy
| | - A. Vanazzi
- Division of Clinical Haemato-Oncology; IEO; Milan Italy
| | - S. Hohaus
- Institute of Hematology; Catholic Unicversityof the Sacred Heart; Rome Italy
| | - P. Mazza
- Department of Hematology-Oncology; Ospedale Moscati; Taranto Italy
| | - S. Molica
- Hematology; Azienda Ospedaliera Pugliese-Ciaccio; Catanzaro Italy
| | - P. Corradini
- Hematology; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - F. Gaudio
- Hematology; Policlinico di Bari; Bari Italy
| | - F. Ronconi
- Division of Hematology and Stem Cell Transplantation Unit; Cardarelli Hospital; Naples Italy
| | - A. Pinto
- Hematology-Oncology and Stem Cell Transplantation Unit; National Cancer Institute, Fondazione Pascale, IRCCS; Naples Italy
| | - V. Pavone
- Hematology; Ospedale G. Panico; Lecce Italy
| | - S. Volpetti
- Hematology; Azienda Sanitaria Universitaria Integrata; Udine Italy
| | - A. Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine; University of Padua; Padova Italy
| | - M. Bonfichi
- Hematology; IRCCS Policlinico San Matteo; Pavia Italy
| | | | - M. Spina
- Division of Medical Oncology A; National Cancer Institute; Aviano Italy
| | - A. Carella
- Division of Hematology 1; IRCCS A.O.U. San Martino IST; Genoa Italy
| | - L. Argnani
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
| | - P. Zinzani
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
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Mian M, Marcheselli L, Rossi A, Visco C, Chiappella A, Volpetti S, Zaja F, Mondello P, Fiegl M, Billio A, Federico M, Luminari S, Rambaldi A, Cortelazzo S. A diachronic-comparative analysis for the identification of the most powerful prognostic index for localized diffuse large B-cell lymphoma. Ann Oncol 2014; 25:2398-2404. [PMID: 25274614 DOI: 10.1093/annonc/mdu462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In the rituximab era, the conventional International Prognostic index (IPI) lost at least in part its predictive power, while the National Comprehensive Cancer Network-IPI (NCCN-IPI) seems to be a new and valid prognosticator. However, it has not yet been evaluated in patients with localized disease and it has not been compared with the modified IPI (mIPI) of the pre-rituximab era. In order to evaluate the different prognosticators and to assess the importance of rituximab and radiotherapy (RT), we carried out the so far largest retrospective analysis of patients with localized diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS We retrospectively assessed clinical and therapeutical data of 1405 patients treated in from 1987 to 2012 in 10 cancer centers in Italy and 1 in Austria. RESULTS All patients underwent an anthracycline containing polychemotherapy and 254 additional rituximab. The median follow-up was 5.7 years (range 0.1-23 years). The 5-year overall survival (OS) was 75%, being significantly superior in those who underwent additional rituximab, while RT consolidation did not improve the outcome of those who received immunochemotherapy. Patients with extranodal disease benefited from the addition of rituximab, while RT did not improve OS of the immunochemotherapy subgroup. In the pre-rituximab era, the mIPI showed a better performance than the others. In rituximab-treated patients, the NCCN-IPI had the highest discriminant value and the 5-years OS varied significantly (P < 0.001) between the three risk groups and was 98% in low-risk patients, 82% in those with a low-intermediate risk and 57% among high-intermediate and high-risk cases. CONCLUSIONS The NCCN-IPI is so far the best prognosticator for patients with localized DLBCL who underwent R-CHOP(-like). The addition of rituximab is indispensable regardless of the risk category and site of involvement, while the addition of RT should be reserved to those cases who are ineligible to rituximab.
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Affiliation(s)
- M Mian
- Division of Hematology, Hospital of Bolzano, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Austria.
| | - L Marcheselli
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
| | - A Rossi
- USC Hematology, A.O. Papa Giovanni XXIII, Bergamo
| | - C Visco
- Department of Hematology, Ospedale San Bortolo, Vicenza
| | - A Chiappella
- Division of Hematology 2, Azienda Ospedaliera Città Della Salute e Della Scienza, Turin
| | - S Volpetti
- Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliero-Universitaria Udine, Udine
| | - F Zaja
- Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliero-Universitaria Udine, Udine
| | - P Mondello
- Department of Medical Oncology, University of Messina, Messina
| | - M Fiegl
- Department of Hematology and Oncology, University Hospital Innsbruck, Austria
| | - A Billio
- Division of Hematology, Hospital of Bolzano, Bolzano, Italy
| | - M Federico
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
| | - S Luminari
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
| | - A Rambaldi
- USC Hematology, A.O. Papa Giovanni XXIII, Bergamo
| | - S Cortelazzo
- Department of Medical Oncology and Hematology, Humanitas Cancer Center, Bergamo, Italy
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Candoni A, Simeone E, Buttignol S, Volpetti S, Lazzarotto T, Pipan C, Fanin R. Late onset cytomegalovirus encephalitis after reduced-intensity conditioning allogeneic SCT: an emerging neurological complication? Bone Marrow Transplant 2010; 46:455-6. [DOI: 10.1038/bmt.2010.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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