Autologous transplant for primary mediastinal B-cell lymphoma

Abstract

Evaluation of: Rodriguez J, Conde E, Gutierrez A et al. Primary mediastinal large cell lymphoma (PMBCL) frontline treatment with autologous stem cell transplantation (ASCT). The GEL-TAMO experience. Hematol. Oncol. 26, 171–178 (2008).

Primary mediastinal large B-cell lymphoma (PMBCL) is a subtype of lymphoma that shares similarities with diffuse large B-cell lymphoma and with classic Hodgkin’s lymphoma. The current study evaluates the use of autologous stem cell transplant (ASCT) as part of initial therapy in a cohort of patients with PMBCL treated between 1985 and 2006. The study demonstrates excellent survival and progression-free survival for patients in complete remission (CR) at ASCT, and for those achieving CR after ASCT. It also shows a benefit to administration of involved-field radiation therapy. However, front-line therapy has evolved considerably since these patients were treated. Dose-dense chemotherapy regimens show excellent results without transplant and the incorporation of rituximab in the treatment may have further improved outcomes. Given these excellent results, ASCT should not currently be used in patients in first CR, but ASCT remains the treatment of choice in relapsed and refractory PMBCL. Similarly, radiotherapy is unnecessary in patients in first CR but is probably useful in patients with residual active mass.

Keywords::

• autologous stem cell transplant
• frontline therapy
• primary mediastinal large B-cell lymphoma
• radiotherapy
• risk factor
• rituximab

Financial & competing interests disclosure

X Poiré is supported by a grant from Franqui-De Roover Foundation (Salus Sanguinis), Brussels, Belgium. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.