Clinical Scorecard: GMALL B-ALL/NHL 2002 Protocol in High-Grade B-Cell Lymphoma

At a Glance

Key Highlights

• Among 53 treated patients, 42 (79.2%) achieved metabolic complete response and 7 (13.2%) achieved partial response at end of treatment.
• Six-year progression-free survival was 72% overall, 83% for HGBCL, NOS, and 49% for DHL.
• Six-year overall survival was 76% overall, 86% for HGBCL, NOS, and 56% for DHL.
• Therapy-related adverse reactions were reported in 25 patients; febrile neutropenia occurred in 12, sepsis in 4, and mucositis in 9.
• One patient developed therapy-related myelodysplastic syndrome, which progressed and caused death.

Guideline-Based Recommendations

Diagnosis

Management

Monitoring & Follow-up

Risks

Patient & Prescribing Data

The cohort included 53 patients: 34 with HGBCL, NOS and 19 with DHL. Median age was 56 years (range 21–75); 27 patients were older than 55.

Thirty-six patients received full-intensity treatment, including 10 older than 55; 17 received the age-reduced schedule. Toxic adverse events required reduced dose intensity in five patients.

Clinical Best Practices

• The cohort used tissue biopsy for histological confirmation and FISH to assess MYC, BCL2, and BCL6 rearrangements.
• The cohort assessed response with Lugano criteria and scheduled CT/PET imaging as described in the protocol.
• The protocol included intrathecal treatment during cycles A and B; for patients with CNS involvement, treatment continued until three negative results were documented.
• The article describes limited consensus on front-line HGBCL treatment and reports outcomes from a single-institution cohort.

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