Impact of rituximab on treatment outcomes of patients with angioimmunoblastic T-cell lymphoma; a population-based analysis.
Humans
Rituximab
/ therapeutic use
Hematopoietic Stem Cell Transplantation
Lymphoma, Large B-Cell, Diffuse
/ pathology
Epstein-Barr Virus Infections
Antibodies, Monoclonal, Murine-Derived
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Transplantation, Autologous
Herpesvirus 4, Human
Retrospective Studies
Neoplasm Recurrence, Local
Vincristine
/ therapeutic use
Cyclophosphamide
/ therapeutic use
Prednisone
/ therapeutic use
Treatment Outcome
Doxorubicin
/ therapeutic use
Lymphoma, T-Cell
/ drug therapy
Angioimmunoblastic T-cell lymphoma
Outcome
Peripheral T-cell lymphoma
Rituximab
Treatment
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
17
06
2022
revised:
08
09
2022
accepted:
08
09
2022
pubmed:
9
10
2022
medline:
22
11
2022
entrez:
8
10
2022
Statut:
ppublish
Résumé
Patients with angioimmunoblastic T-cell lymphoma (AITL) are treated with cyclophosphamide, doxorubicin, vincristine and prednisone with or without etoposide (CHO(E)P). In the majority of cases, Epstein-Barr virus (EBV)-positive B-cells are present in the tumour. There is paucity of research examining the effect of rituximab when added to CHO(E)P. In this nationwide, population-based study, we analysed the impact of rituximab on overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) of patients with AITL. Patients with AITL diagnosed between 2014 and 2020 treated with ≥one cycle of CHO(E)P with or without rituximab were identified in the Netherlands Cancer Registry. Survival follow-up was up to 1st February 2022. Baseline characteristics, best response during first-line treatment and survival were collected. PFS was defined as the time from diagnosis to relapse or to all-cause-death. OS was defined as the time from diagnosis to all-cause-death. Multivariable analysis for the risk of mortality was performed using Cox regression. Out of 335 patients, 146 patients (44%) received R-CHO(E)P. Rituximab was more frequently used in patients with a B-cell infiltrate (71% versus 89%, p < 0·01). The proportion of patients who received autologous stem cell transplantation (ASCT) was similar between CHO(E)P and R-CHO(E)P (27% versus 30%, respectively). The ORR and 2-year PFS for patients who received CHO(E)P and R-CHO(E)P were 71% and 78% (p = 0·01), and 40% and 45% (p = 0·12), respectively. The 5-year OS was 47% and 40% (p = 0·99), respectively. In multivariable analysis, IPI-score 3-5, no B-cell infiltrate and no ASCT were independent prognostic factors for risk of mortality, whereas the use of rituximab was not. Although the addition of rituximab to CHO(E)P improved ORR for patients with AITL, the PFS and OS did not improve.
Sections du résumé
BACKGROUND
Patients with angioimmunoblastic T-cell lymphoma (AITL) are treated with cyclophosphamide, doxorubicin, vincristine and prednisone with or without etoposide (CHO(E)P). In the majority of cases, Epstein-Barr virus (EBV)-positive B-cells are present in the tumour. There is paucity of research examining the effect of rituximab when added to CHO(E)P. In this nationwide, population-based study, we analysed the impact of rituximab on overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) of patients with AITL.
METHODS
Patients with AITL diagnosed between 2014 and 2020 treated with ≥one cycle of CHO(E)P with or without rituximab were identified in the Netherlands Cancer Registry. Survival follow-up was up to 1st February 2022. Baseline characteristics, best response during first-line treatment and survival were collected. PFS was defined as the time from diagnosis to relapse or to all-cause-death. OS was defined as the time from diagnosis to all-cause-death. Multivariable analysis for the risk of mortality was performed using Cox regression.
FINDINGS
Out of 335 patients, 146 patients (44%) received R-CHO(E)P. Rituximab was more frequently used in patients with a B-cell infiltrate (71% versus 89%, p < 0·01). The proportion of patients who received autologous stem cell transplantation (ASCT) was similar between CHO(E)P and R-CHO(E)P (27% versus 30%, respectively). The ORR and 2-year PFS for patients who received CHO(E)P and R-CHO(E)P were 71% and 78% (p = 0·01), and 40% and 45% (p = 0·12), respectively. The 5-year OS was 47% and 40% (p = 0·99), respectively. In multivariable analysis, IPI-score 3-5, no B-cell infiltrate and no ASCT were independent prognostic factors for risk of mortality, whereas the use of rituximab was not.
INTERPRETATION
Although the addition of rituximab to CHO(E)P improved ORR for patients with AITL, the PFS and OS did not improve.
Identifiants
pubmed: 36208568
pii: S0959-8049(22)00743-2
doi: 10.1016/j.ejca.2022.09.008
pii:
doi:
Substances chimiques
Rituximab
4F4X42SYQ6
Antibodies, Monoclonal, Murine-Derived
0
Vincristine
5J49Q6B70F
Cyclophosphamide
8N3DW7272P
Prednisone
VB0R961HZT
Doxorubicin
80168379AG
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
100-109Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.