RT Journal Article
T1 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.
A1 Martín, Alejandro
A1 Conde, Eulogio
A1 Arnan, Montserrat
A1 Canales, Miguel A
A1 Deben, Guillermo
A1 Sancho, Juan M
A1 Andreu, Rafael
A1 Salar, Antonio
A1 García-Sanchez, Pedro
A1 Vázquez, Lourdes
A1 Nistal, Sara
A1 Requena, María-José
A1 Donato, Eva M
A1 González, José A
A1 León, Angel
A1 Ruiz, Concepción
A1 Grande, Carlos
A1 González-Barca, Eva
A1 Caballero, María-Dolores
K1 R-ESHAP
K1 Diffuse large B-Cell lymphoma
K1 Rituximab
K1 Salvage therapy
K1 Protocolos de quimioterapia antineoplásica combinada
K1 Tratamiento de última línea
K1 Linfoma de células B grandes difuso
AB BACKGROUNDThe 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 METHODSWe 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.RESULTSResponse 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).CONCLUSIONSR-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.
PB Ferrata Storti Foundation
SN 0390-6078
YR 2008
FD 2008-12
LK http://hdl.handle.net/10668/1286
UL http://hdl.handle.net/10668/1286
LA en
NO 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
NO 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)
DS RISalud
RD May 5, 2025