Table 1.
Clinicopathologic characteristics of patients with PMBCL treated with different chemotherapy regimens.
| First-line treatment | R-CHOP | R-EPOCH | R-HCAVD | ||
|---|---|---|---|---|---|
| Characteristic | n (%) | n (%) | P1 | n (%) | P2 |
| Age | |||||
| ≤60 years | 89 (100) | 53 (96.4) | 0.14 | 18 (94.7) | 0.18 |
| >60 years | 0 (0) | 2 (3.6) | 1 (5.3) | ||
| Sex | |||||
| Female | 51 (57.3) | 29 (52.7) | 0.61 | 13 (68.4) | 0.45 |
| Male | 38 (42.7) | 26 (47.3) | 6 (31.6) | ||
| Stage | |||||
| I–II | 67 (77.0) | 39 (70.9) | 0.43 | 12 (63.2) | 0.25 |
| III–IV | 20 (23.0) | 16 (29.1) | 7 (36.8) | ||
| B-symptoms | |||||
| No | 53 (59.6) | 33 (61.1) | 1.0 | 12 (63.2) | 1.0 |
| Yes | 36 (40.4) | 21 (38.9) | 7 (36.8) | ||
| Serum LDH | |||||
| Normal | 29 (37.2) | 13 (25) | 0.18 | 1 (5.6) | 0.0098 |
| Elevated | 49 (62.8) | 39 (75) | 17 (94.4) | ||
| No. of extranodal involvement | |||||
| 0–1 | 84 (96.6) | 52 (94.5) | 0.68 | 16 (84.2) | 0.069 |
| ≥2 | 3 (3.4) | 3 (5.5) | 3 (15.8) | ||
| ECOG performance status | |||||
| 0–1 | 81 (92.0) | 43 (81.1) | 0.065 | 12 (63.2) | 0.003 |
| ≥2 | 7 (8.0) | 10 (18.9) | 7 (36.8) | ||
| Mediastinal mass size | |||||
| ≤10 cm | 40 (54.8) | 22 (41.5) | 0.15 | 7 (36.8) | 0.20 |
| >10 cm | 33 (45.2) | 31 (58.5) | 12 (63.2) | ||
| IPI risk group | |||||
| 0–1 | 67 (81.7) | 37 (68.5) | 0.098 | 11 (57.9) | 0.035 |
| >1 | 15 (18.3) | 17 (31.5) | 8 (42.1) | ||
| Treatment response | |||||
| Complete | 57 (64.0) | 44 (80.0) | 0.06a | 16 (84.2) | 0.11a |
| Partial | 24 (27.0) | 10 (18.2) | 3 (15.8) | ||
| Stable disease | 2 (2.2) | 0 (0) | 0 (0) | ||
| Progressive disease | 6 (6.7) | 1 (1.8) | 0 (0) | ||
| Ki-67 index | |||||
| <70% | 17 (37.8) | 18 (51.4) | 0.26 | 2 (25) | 0.70 |
| ≥70% | 28 (62.2) | 17 (48.6) | 6 (75) | ||
| PET SUVmax at diagnosis | |||||
| ≤11.6 | 16 (31.4) | 4 (10.5) | 0.023 | 4 (25) | 0.76 |
| >11.6 | 35 (68.6) | 34 (89.5) | 12 (75) | ||
| End-of-treatment PET SUVmax | |||||
| ≤5.4 | 53 (86.9) | 44 (89.8) | 0.77 | 17 (100) | 0.19 |
| >5.4 | 8 (13.1) | 5 (10.2) | 0 (0) | ||
| CBC lymphocyte count | |||||
| ≤1.2.1 × 109/L | 22 (64.7) | 25 (58.1) | 0.64 | 14 (73.7) | 0.56 |
| >1.2.1 × 109/L | 12 (35.3) | 18 (41.9) | 5 (26.3) | ||
| CBC lymphocyte:monocyte ratio | |||||
| ≤0.1 | 14 (41.2) | 22 (51.2) | 0.49 | 14 (73.7) | 0.043 |
| >0.1 | 20 (58.8) | 21 (48.8) | 5 (26.3) | ||
| CD30 expression | |||||
| Negative | 20 (27.8) | 15 (31.3) | 0.69 | 2 (13.3) | 0.34 |
| Positive | 52 (72.2) | 33 (68.8) | 13 (86.7) | ||
| MUM1 expression | |||||
| Negative | 4 (22.2) | 4 (13.8) | 0.69 | 0 (0) | 0.55 |
| Positive | 14 (77.8) | 25 (86.2) | 4 (100) | ||
| Radiation therapy | |||||
| No | 10 (15.6) | 8 (30.8) | 0.14 | 1 (7.7) | 0.68 |
| Yes | 54 (84.4) | 18 (69.2) | 12 (92.3) | ||
| Stem cell transplant | |||||
| No | 70 (78.7) | 46 (83.6) | 0.52 | 17 (89.5) | 0.36 |
| Yes | 19 (21.3) | 9 (16.4) | 2 (10.5) | ||
Significant P-values are in bold.
PMBCL primary mediastinal large B-cell lymphoma, LDH lactate dehydrogenase, ECOG Eastern Cooperative Oncology Group, IPI International Prognostic Index, R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, R-EPOCH rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin, R-HCVAD rituximab, cyclophosphamide, mesna, doxorubicin, vincristine, dexamethasone, methotrexate, and cytarabine, PET positron emission tomography, SUVmax maximum standardized uptake value, CBC complete blood count.
P1 R-EPOCH vs R-CHOP group, P2 R-HCVAD vs R-CHOP group.
aCR vs. non-CR.