De novo CD5+diffuse large B-cell lymphoma: Adverse outcomes with and without stem cell transplantation in a large, multicenter, rituximab treated cohort

• Type of Material: Article
• Authors: Lapo Alinari, Ohio State University; Alejandro Gru, Ohio State University; Carl Quinion, Ohio State University; Ying Huang, Ohio State University; Arletta Lozanski, Ohio State University; Gerard Lozanski, Ohio State University; Jacqueline Poston, University of Chicago; Girish Venkataraman, University of Chicago; Eunhye Oak, Washington University; Freiderike Kreisel, Washington University; Steven I. Park, University of North Carolina; Stephanie Matthews, University of North Carolina; Jeremy S. Abramson, Harvard University; Hana Iris Lim, Weill Cornell Medical College; Peter Martin, Weill Cornell Medical College; Jonathon Cohen, Emory University; Andrew Evens, Tufts University; Zeina Al-Mansour, University of Massachusetts Medical School; Arun Singavi, Medical College of Wisconsin; Timothy S. Fenske, Medical College of Wisconsin; Kristie A. Blum, Ohio State University
• Language: English
• Date: 2016-03-18
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Wiley Periodicals, Inc. This is the peer reviewed version of the following article: Alinari, L., Gru, A., Quinion, C., Huang, Y., Lozanski, A., Lozanski, G., Poston, J., Venkataraman, G., Oak, E., Kreisel, F., Park, S. I., Matthews, S., Abramson, J. S., Iris Lim, H., Martin, P., Cohen, J. B., Evens, A., Al-Mansour, Z., Singavi, A., Fenske, T. S. and Blum, K. A. (2016), De novo CD5+ diffuse large B-cell lymphoma: Adverse outcomes with and without stem cell transplantation in a large, multicenter, rituximab treated cohort. Am. J. Hematol., 91: 395–399. doi:10.1002/ajh.24299, which has been published in final form at http://dx.doi.org/10.1002/ajh.24299. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Final Published Version (URL): http://dx.doi.org/10.1002/ajh.24299
• Title of Journal or Parent Work: American Journal of Hematology
• ISSN: 0361-8609
• Volume: 91
• Issue: 4
• Start Page: 395
• End Page: 399
• Keywords: CHEMOTHERAPY; EXPRESSION; Hematology; Science & Technology; THERAPY; Life Sciences & Biomedicine; CHOP
• Research Categories: Health Sciences, Pathology; Health Sciences, Medicine and Surgery

Abstract

De novo CD5+ diffuse large B-cell lymphomas (DLBCL) are a distinct subgroup of DLBCL with poor prognosis. However the role of rituximab-containing therapy and salvage stem cell transplantation in this patients' population remain to be defined. We retrospectively reviewed clinical features and outcomes of 102 patients with de novo CD5+ DLBCL treated with rituximab-containing therapy at nine different institutions. By Hans' criteria, 64 patients had activated B-cell (ABC) subtype, 24 germinal center B-cell (GCB) subtype, and 14 were not evaluated. No patients had a myc translocation. Eighty-three patients were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP), 7 with rituximab, etoposide, cyclophosphamide, doxorubicin, vincristine, prednisone (R-EPOCH), and 6 with R-CHOP with methotrexate, 3 g/m2. The overall response rate to front-line therapy was 85%. The 3-year progression free survival (PFS) and overall survival (OS) for all patients were 40 and 65%, respectively. The 3-year PFS for ABC- and GCB-subtypes was 34 and 45%, respectively. The 3-year OS for ABC- and GCB-subtypes was 62 and 67%, respectively. The median time to second treatment failure was 3 months and 1 month for ABC- and GCB-subtypes, respectively. Twenty of 28 (71%) transplanted patients with autologous, allogeneic, or both, relapsed. This study confirms the poor prognosis of de novo CD5+ DLBCL in a large multi-center cohort despite initial rituximab-containing chemotherapy and suggests that stem cell transplantation fails to salvage the majority of these patients. Approaches to prevent recurrence and/or novel therapies for relapsed disease are needed for this subgroup of DLBCL patients.