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 Detalle_Publicacion

Intensification treatment based on early FDG-PET in patients with high-risk diffuse large B-cell lymphoma: a phase II GELTAMO trial

Abstract: We conducted a multicentre, phase II study of interim positron emission tomography (PET) as a guide to risk-adapted therapy in high-risk patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Patients achieving negative fluorodeoxyglucose (FDG)-PET after three courses of R-MegaCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) received three additional courses, whereas PET-positive patients received two courses of R-IFE (rituximab, ifosfamide, etoposide) followed by BEAM (BCNU, etoposide, cytarabine, melphalan) and autologous stem-cell transplantation. The primary endpoint was progression-free survival (PFS). 71 patients (median age 55 years, range 25–69) were enrolled. With a median follow-up of 42·8 months (range 7·2–58·4), the estimated 4-year PFS and overall survival (OS) were 67% and 78%, respectively, for the global series. Patients in complete remission after interim PET (N = 36) had significantly better 3-year PFS than those with partial response (N = 30) [81% vs. 57%, Hazard ratio (HR) = 2·6, 95% confidence interval (CI) = 1·02–6·65] but not a statistically significant longer OS. A retrospective PET central review was done for 51 patients. According to semiquantitative analysis, 3-year PFS (81% vs. 33%; HR = 6·9, 95% CI = 2·35–20·6) and OS (95% vs. 33%, HR = 19·4, 95% CI = 3·89–97·0) were significantly better for negative than for positive interim PET patients. Early PET assessment is valuable for risk stratification in DLBCL; for this purpose semiquantitative evaluation is a better predictor than visual criteria.

 Fuente: British Journal of Haematology, 2014, 167, 327–336

Editorial: Blackwell Publishing Ltd

 Año de publicación: 2014

Nº de páginas: 10

Tipo de publicación: Artículo de Revista

 DOI: 10.1111/bjh.13036

ISSN: 0007-1048,1365-2141

Autores/as

PARDAL, EMILIA

CORONADO, MÓNICA

MARTÍN, ALEJANDRO

GRANDE, CARLOS

MARÍN-NIEBLA, ANA

PANIZO, CARLOS

BELLO, JOSÉ LUIS

EULOGIO CONDE GARCIA

HERNÁNDEZ, MIGUEL T.

ARRANZ, REYES

BARGAY, JOAN

GONZÁLEZ-BARCA, EVA

PÉREZ-CEBALLOS, ELENA

SANTIAGO MONTES MORENO

CABALLERO, MARÍA DOLORES