Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/1286
Título : R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study.
Autor : Martín, Alejandro
Conde, Eulogio
Arnan, Montserrat
Canales, Miguel A
Deben, Guillermo
Sancho, Juan M
Andreu, Rafael
Salar, Antonio
García-Sanchez, Pedro
Vázquez, Lourdes
Nistal, Sara
Requena, María-José
Donato, Eva M
González, José A
León, Angel
Ruiz, Concepción
Grande, Carlos
González-Barca, Eva
Caballero, María-Dolores
Filiación: [Martín,A] Complejo Hospitalario de Zamora. [Conde,E] Hospital Marqués de Valdecilla, Santander. [Arnan,M; González-Barca,E] Hospital Duran i Reynals, L’Hospitalet de Llobregat. [Canales,MA] Hospital La Paz, Madrid; [Deben,G] Hospital Juan Canalejo, La Coruña. [Sancho,JM] Hospital Germans Trias i Pujol, Badalona. [Andreu,R] Hospital Dr. Peset, Valencia. [Salar,A] Hospital del Mar, Barcelona. [García-Sanchez,P] Hospital Clínico de Madrid. [Vázquez,L; Caballero,MD] Hospital Universitario de Salamanca. [Nistal,S] Hospital Universitario de Getafe. [Requena,MJ] Hospital Severo Ochoa, Leganés. [Donato,EM] Hospital General de Castellón. [González, JA] Hospital Virgen del Puerto, Plasencia. [León,A] Hospital General de Jerez, Jerez de la Frontera. [Ruiz,C] Hospital Carlos Haya, Málaga. [Grande,C] Hospital Doce de Octubre, Madrid, Spain.
Grupo de Investigación: Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea (GEL/TAMO cooperative group)
Palabras clave : R-ESHAP
Diffuse large B-Cell lymphoma
Rituximab
Salvage therapy
Protocolos de quimioterapia antineoplásica combinada
Tratamiento de última línea
Linfoma de células B grandes difuso
MeSH: Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal::Antibodies, Monoclonal, Murine-Derived
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Clinical Protocols::Antineoplastic Protocols::Antineoplastic Combined Chemotherapy Protocols
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Chlorine Compounds::Cisplatin
Medical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Pyrimidines::Pyrimidine Nucleosides::Cytidine::Cytarabine
Medical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Steroids, Fluorinated::Dexamethasone
Medical Subject Headings::Chemicals and Drugs::Carbohydrates::Glycosides::Glucosides::Etoposide
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Diseases::Immune System Diseases::Immunoproliferative Disorders::Lymphoproliferative Disorders::Lymphoma::Lymphoma, Non-Hodgkin::Lymphoma, B-Cell::Lymphoma, Large B-Cell, Diffuse
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Retrospective Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Salvage Therapy
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Young Adult
Medical Subject Headings::Named Groups::Persons::Age Groups::Adolescent
Fecha de publicación : Dec-2008
Editorial : Ferrata Storti Foundation
Cita Bibliográfica: Martín A, Conde E, Arnan M, Canales MA, Deben G, Sancho JM, et al. R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study. Haematologica. 2008 ; 93(12):1829-36
Abstract: BACKGROUND The role of re-treatment with rituximab in aggressive B-cell lymphomas still needs to be defined. This study evaluated the influence of prior exposure to rituximab on response rates and survival in patients with diffuse large B-cell lymphoma treated with rituximab plus etoposide, cytarabine, cisplatinum and methylprednisolone (R-ESHAP). DESIGN AND METHODS We retrospectively analyzed 163 patients with relapsed or refractory diffuse large B-cell lymphoma who received R-ESHAP as salvage therapy with a curative purpose. Patients were divided into two groups according to whether rituximab had been administered (n=94, "R+" group) or not (n=69, "R-" group) prior to R-ESHAP. RESULTS Response rates were significantly higher in the R- group in the univariate but not in the multivariate analysis. In the analysis restricted to the R+ group, we observed very low complete remission and overall response rates in patients with primary refractory disease (8% and 33%, respectively), as compared to those in patients who were in first partial remission (41% and 86%) or who had relapsed disease (50% and 75%) (p<0.01 in both cases). Overall, 60% and 65% of patients in the R+ and R- groups, respectively, underwent stem-cell transplantation after the salvage therapy. With a median follow-up of 29 months (range, 6-84), patients in the R+ group had significantly worse progression-free survival (17% vs. 57% at 3 years, p<0.0001) and overall survival (38% v 67% at 3 years, p=0.0005) than patients in the R- group. Prior exposure to rituximab was also an independent adverse prognostic factor for both progression-free survival (RR: 2.0; 95% CI: 1.2-3.3, p=0.008) and overall survival (RR: 2.2; 95% CI: 1.3-3.9, p=0.004). CONCLUSIONS R-ESHAP was associated with a high response rate in patients who were not refractory to upfront rituximab-based chemotherapy. However, the survival outcome was poor for patients previously exposed to rituximab, as compared to in those who had not previously been treated with rituximab.
Descripción : Journal Article; Multicenter Study; "Comment in Salvage therapy for relapsed or refractory diffuse large B-cell lymphoma: impact of prior rituximab. [Haematologica. 2008]" (Nota tomada de PubMed)
URI: http://hdl.handle.net/10668/1286
Versión del editor : http://www.haematologica.org/content/93/12/1829.abstract
DOI: 10.3324/haematol.13440
ISSN : 1592-8721 (Online)
0390-6078 (Print)
Appears in Collections:01- Artículos - Hospital de Jerez
01- Artículos - Hospital Regional de Málaga

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