Impact of induction regimen and stem cell transplantation on outcomes in patients with double hit lymphoma: a large multicenter retrospective analysis Journal Article

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Authors: Petrich, A. M.; Gandhi, M.; Jovanovic, B.; Castillo, J. J.; Rajguru, S.; Yang, D. T.; Shah, K. A.; Whyman, J. D.; Lansigan, F; Hernandez-Ilizaliturri, F. J.; Lee, L. X.; Barta, S. K.; Melinamani, S.; Karmali, R; Adeimy, C.; Smith, S; Dalal, N.; Nabhan, C.; Peace, D.; Vose, J.; Evens, A. M.; Shah, N.; Fenske, T.; Zelenetz, A. D.; Landsburg, D. J.; Howlett, C.; Mato, A.; Jaglal, M; Chavez, J. C.; Tsai, J. P.; Reddy, N; Li, S; Handler, C.; Flowers, C. R.; Cohen, J. B.; Blum, K. A.; Song, K.; Sun, H. L.; Press, O.; Cassaday, R.; Jaso, J.; Medeiros, L. J.; Sohani, A. R.; Abramson, J. S.
Article Title: Impact of induction regimen and stem cell transplantation on outcomes in patients with double hit lymphoma: a large multicenter retrospective analysis
Abstract: Patients with double hit lymphoma (DHL), which is characterized by rearrangements of MYC and either BCL2 or BCL6, face poor prognoses. We conducted a retrospective multicenter study of the impact of baseline clinical factors, induction therapy, and stem cell transplant (SCT), on outcomes of 311 patients with previously-untreated DHL. At median follow-up of 23 months, the median progression free survival (PFS) and overall survival (OS) among all patients were 10.9 and 21.9 months, respectively. Forty percent of patients remain disease-free and 49% remain alive at two years. Intensive induction was associated with improved PFS, but not OS, and SCT was not associated with improved OS among patients achieving first complete remission (p=0.14). By multivariate analysis, advanced stage, central nervous system involvement, leukocytosis, and LDH> three times upper limit of normal, were associated with higher risk of death. Correcting for these, intensive induction was associated with improved OS. We developed a novel risk score for DHL, which divides patients into high, intermediate, and low risk groups. In conclusion, a subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed.
Journal Title: Blood
ISSN: 1528-0020; 0006-4971
Publisher: American Society of Hematology  
Date Published: 2014
Language: ENG
DOI/URL:

blood-2014-05-578963
Notes: CI: Copyright (c) 2014; JID: 7603509; aheadofprint