演題詳細

ポスター / Poster

ポスター 26 (Poster 26) :B細胞性リンパ腫:Chemotherapy

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
塚本 憲史 (Norifumi Tsukamoto):1
1:群馬大学医学部附属病院 腫瘍センター
 
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Is MACOP-B still preferable for untreated PMLBCL? - A retrospective analysis

演題番号 : PS-1-192

清水 郁夫 (Ikuo Shimizu):1,2、武田 航 (Wataru Takeda):1、桐原 健彦 (Takehiko Kirihara):1、佐藤 慶二郎 (Keijiro Sato):1、植木 俊充 (Toshimitsu Ueki):1、廣島 由紀 (Yuki Hiroshima):1、住 昌彦 (Masahiko Sumi):1、上野 真由美 (Mayumi Ueno):1、市川 直明 (Naoaki Ichikawa):1、小林 光 (Hikaru Kobayashi):1

1:Dept. Hematology, Nagano Red Cross Hospital, Nagano, Japan、2:Center for Medical Education, Shinshu Univ. School of Med, Matsumoto, Japan

 

Background: Treatment strategy for primary mediastinal large B-cell lymphoma (PMLBCL), which was introduced as a distinct entity in the 2008 WHO classification, is still a clinical question. MACOP-B has been considered superior to CHOP. In the "rituximab-era," R-CHOP has been shown to improve survival. Consolidation radiotherapy (RT) raises the concern of secondary malignancy. Here, we analyzed the outcome of MACOP-B and RT combination therapy for untreated PMLBCL. Methods: Seven patients (4 men and 3 women; median age, 31; age range, 20-63) with untreated PMLBCL treated at our institute during January 2003 to March 2013 were evaluated. Results: The median stage of patients was 2 (range, 1-3), B symptoms were observed in 1 patient, and elevated LDH was observed in 6. After 6 courses of MACOP-B chemotherapy followed by consolidation RT, while 6 patients achieved remission (CR, 5; PR, 1), 1 patient in PR relapsed 18 months after completion of treatment. Five patients achieved sustained progression-free survival (median duration, 36 months; range, 21-113). A refractory case led early progression to CNS. The following non-hematological toxicities were observed in 1 patient each: radiation pneumonitis, herpes zoster, and pulmonary aspergillosis. No secondary malignancy was observed. Conclusion: Consistent with previous reports, relatively favorable outcomes were achieved with MACOP-B. However, outcomes for refractory/relapsed cases were poor. Based on feasible results with R-CHOP, further strategies should be considered. CNS prophylaxis may be required in selected cases.

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