[Show abstract][Hide abstract] ABSTRACT: Tumour regression after antiviral therapy (AT) is in favour of an etiological role of hepatitis C virus (HCV) in non-Hodgkin's B-cell lymphomas (NHL).
We performed a cohort study of 704 consecutive HIV-negative, HCV-positive patients with indolent NHL diagnosed and treated from 1993 to 2009 in 39 centers of the Fondazione Italiana Linfomi; 134 patients were managed with AT for lymphoma control.
For entire cohort, 5-yr overall survival (OS) was 78% (95%CI: 74-82%) and 5-yr progression-free survival (PFS) was 48% (95%CI: 44-53%). In multivariate analysis, use of AT during the patients' life had positive impact on OS. Fourty four of the 100 patients treated with first-line AT achieved a CR and 33 a partial response (PR). HCV-RNA clearance was achieved in 80 patients and was related to lymphoma response. At a median follow-up of 3.6 years, 5-yr PFS was 63% (95%CI: 50%-73%). CR+PR rate was 85% with AT as second-line treatment.
AT produces HCV-RNA clearance and consequent tumour regression in most patients with HCV-related indolent NHL. AT used at any time is associated with improved OS. Consequently, AT can be considered an option for patients with indolent lymphomas who do not need immediate cytoreductive treatment.
[Show abstract][Hide abstract] ABSTRACT: A prospective, single-arm, open-label, multicenter, nonrandomised phase II trial to evaluate efficacy and safety of short fludarabine, mitoxantrone, and rituximab (FMR) induction followed by radioimmunotherapy, in untreated, intermediate/high-risk follicular non-Hodgkin's lymphoma (NHL) patients.
Fifty-five patients were treated using a sequential treatment schedule of four induction cycles of FMR chemoimmunotherapy, and a subsequent consolidating single administration of (90)Y-ibritumomab tiuxetan ((90)Y-IT), 8-14 weeks later. Patients were eligible for radioimmunotherapy if at least in partial response (PR) after induction, with normal platelet and granulocyte counts and a bone marrow infiltration ≤ 25%. Primary study end points were response rate and hematologic toxic effects; secondary end points were overall survival (OS) and progression-free survival (PFS).
All the 55 patients received four induction cycles with an overall response rate of 96% (38 complete responses [CR] and 15 PR). Fifty-one patients (38 in CR and 13 in PR) received (90)Y-IT. By the end of the treatment, 49/55 patients achieved a CR. With a median follow-up of 21 months, the estimated 3-year PFS was 81% and the 3-year OS 100%.
This study has established feasibility, tolerability, and efficacy of a regimen composed by short FMR induction with (90)Y-IT consolidation in untreated intermediate/high-risk follicular NHL patients.
Annals of Oncology 05/2011; 23(2):415-20. · 7.38 Impact Factor