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• W3135264752 abstract "In The Lancet Haematology, Fabian Frontzek and colleagues 1 Frontzek F Ziepert M Nickelsen M et al. Rituximab plus high-dose chemotherapy (MegaCHOEP) or conventional chemotherapy (CHOEP-14) in young, high-risk patients with aggressive B-cell lymphoma: 10-year follow-up of a randomised, phase 3 trial. Lancet Haematol. 2021; (published online March 2.)https://doi.org/10.1016/S2352-3026(21)00022-3 Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar report an impressive 10-year follow-up of the phase 3 DSHNHL 2002-1 trial, which compared R-CHOEP-14 (conventional chemotherapy [cyclosphosphamide, doxorubicin, vincristine, etoposide, and prednisolone] plus rituximab) with the dose-intensified regimen R-MegaCHOEP (high-dose chemotherapy plus rituximab followed by autologous haematopoietic stem-cell transplantation) in patients aged 18–60 years with high-risk aggressive B-cell non-Hodgkin lymphoma. The study affirms several observations about diffuse large B-cell lymphoma and its therapy: intensified chemotherapy is not associated with superior outcomes; 2 Fisher RI Gaynor ER Dahlberg S et al. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993; 328: 1002-1006 Crossref PubMed Scopus (1971) Google Scholar , 3 Bartlett NL Wilson WH Jung SH et al. Dose-adjusted EPOCH-R compared with R-CHOP as frontline therapy for diffuse large B-cell lymphoma: clinical outcomes of the phase III intergroup trial alliance/CALGB 50303. J Clin Oncol. 2019; 37: 1790-1799 Crossref PubMed Scopus (131) Google Scholar , 4 Chiappella A Martelli M Angelucci E et al. Rituximab-dose-dense chemotherapy with or without high-dose chemotherapy plus autologous stem-cell transplantation in high-risk diffuse large B-cell lymphoma (DLCL04): final results of a multicentre, open-label, randomised, controlled, phase 3 study. Lancet Oncol. 2017; 18: 1076-1088 Summary Full Text Full Text PDF PubMed Scopus (64) Google Scholar relapse with indolent lymphoma is favorable; 5 Wang Y Farooq U Link BK et al. Late relapses in patients with diffuse large B-cell lymphoma treated with immunochemotherapy. J Clin Oncol. 2019; 37: 1819-1827 Crossref PubMed Scopus (20) Google Scholar CNS relapses are associated with poor prognosis; 6 El-Galaly TC Cheah CY Bendtsen MD et al. Treatment strategies, outcomes and prognostic factors in 291 patients with secondary CNS involvement by diffuse large B-cell lymphoma. Eur J Cancer. 2018; 93: 57-68 Summary Full Text Full Text PDF PubMed Scopus (35) Google Scholar and patients remaining in remission at 1–2 years after treatment have excellent outcomes. 7 Shi Q Schmitz N Ou FS et al. Progression-free survival as a surrogate end point for overall survival in first-line diffuse large B-cell lymphoma: an individual patient-level analysis of multiple randomized trials (SEAL). J Clin Oncol. 2018; 36: 2593-2602 Crossref PubMed Scopus (40) Google Scholar These findings are important, but not novel. The high merit of this report lies in its long follow-up, which eloquently underscores why and how cumulative and long-term toxicities should be studied. Rituximab plus high-dose chemotherapy (MegaCHOEP) or conventional chemotherapy (CHOEP-14) in young, high-risk patients with aggressive B-cell lymphoma: 10-year follow-up of a randomised, open-label, phase 3 trialEvent-free survival and overall survival were similar between groups after 10 years of follow-up; outcomes were not improved in the R-MegaCHOEP group by high-dose chemotherapy and autologous HSCT. Patients who relapsed with aggressive histology showed a high incidence of CNS involvement and poor prognosis. For these patients, novel therapies are greatly warranted. Full-Text PDF" @default.
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• W3135264752 date "2021-04-01" @default.
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• W3135264752 title "Late toxicities in non-Hodgkin lymphoma: extended follow-up matters" @default.
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• W3135264752 doi "https://doi.org/10.1016/s2352-3026(21)00058-2" @default.
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