To report outcomes and toxicity among patients with high-grade B-cell lymphoma (HGBCL) treated with the GMALL B-ALL/NHL 2002 protocol at one institution.
Approach:
Design and cohort: Institutional treatment experience from February 2011 to December 2023 included 53 patients: 34 with HGBCL, NOS, and 19 with double-hit lymphoma (DHL). Diagnoses were confirmed by tissue biopsy; MYC, BCL2, and BCL6 rearrangements were assessed by FISH.
Treatment and assessment: Patients received stage- and age-adapted GMALL B-ALL/NHL 2002 chemotherapy with rituximab and intrathecal therapy. Response was assessed using Lugano criteria and CT/PET imaging.
Key Findings:
At end of treatment, 42 patients (79.2%) achieved metabolic complete response and 7 (13.2%) partial response; 4 had no clinically meaningful response.
At six years, progression-free survival was 72% overall (83% for HGBCL, NOS; 49% for DHL), and overall survival was 76% (86% and 56%, respectively).
Six-year PFS was 61% among patients older than 55 years and 82% among younger patients. In the older subgroup, three-year PFS was 88% after full-course therapy versus 68% after age-reduced therapy.
Therapy-related adverse reactions were reported in 25 patients. Febrile neutropenia occurred in 12 (22.6%), sepsis in 4 (7.5%), and mucositis in 9 (16.9%). No treatment deaths were attributed directly to protocol adverse events; one patient developed fatal the…
Univariate analysis associated lower response probability with ECOG performance status 2–4 and elevated LDH. DHL histology was associated with inferior PFS.
Interpretation:
In this single-institution cohort, the protocol was associated with high complete-response rates and reported six-year survival outcomes. Outcomes differed by histology and age; the authors note that extended follow-up is needed to assess effects on the bone marrow stem cell reservoir.
Limitations:
The report describes a single-institution cohort of 53 patients.
The supplied context does not provide the complete results of the univariate PFS analysis or all supplementary analyses.
Follow-up was a median of 4.5 years, with a range of 0.4–13 years.
by Silvia Ferrari, Francesco Ballardini, Andrea Rossi, Anna Grassi, Chiara Pavoni, Monica Rondi, Paolo Fruscella, Andrea Gianatti, Giuseppe Gritti, Anna Maria Barbui, Federico Lussana, Alessandro Rambaldi
Antibody-drug conjugates (ADCs) have become an increasingly important part of treatment for several advanced cancers, pairing a tumor-targeting antibody with a cytotoxic payload.
