@article{PL Zinzani_M Martelli_M Bertini_AM Gianni_L Devizzi_M Federico_G Pangalis_J Michels_E Zucca_M Cantonetti_S Cortelazzo_A Wotherspoon_AJ Ferreri_F Zaja_F Lauria_A De Renzo_MA Liberati_B Falini_M Balzarotti_A Calderoni_A Zaccaria_P Gentilini_PP Fattori_E Pavone_MK Angelopoulou_L Alinari_M Brugiatelli_N Di Renzo_F Bonifazi_SA Pileri_F Cavalli_International Extranodal Lymphoma Study Group (IELSG)_2002, place={Pavia, Italy}, title={Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients}, volume={87}, url={https://haematologica.org/article/view/2577}, DOI={10.3324/%x}, abstractNote={BACKGROUND AND OBJECTIVES: This multinational retrospective study compares the outcomes of patients with primary mediastinal large B-cell lymphoma (PMLBCL) with sclerosis after first-generation (dose-intensive regimens), third-generation (alternating regimens) and high-dose chemotherapy strategies, frequently with adjuvant radiation therapy. DESIGN AND METHODS: Between August 1981 and December 1999, a total of 426 previously untreated patients with confirmed diagnosis were enrolled in 20 institutions to receive combination chemotherapy with either first generation (CHOP or CHOP-like) regimens, third generation (MACOP-B, VACOP-B, ProMACE CytaBOM) regimens or high-dose chemotherapy (HDS/ABMT). RESULTS: With chemotherapy, complete response (CR) rates were 49% (50/105), 51% (142/277) and 53% (23/44) with first generation, third generation and high-dose chemotherapy strategies, respectively; partial response (PR) rates were 32%, 36% and 35%, respectively. All patients who achieved CR and 124/142 (84%) with PR had radiation therapy on the mediastinum. The final CR rates became 61% for CHOP/CHOP-like regimens, 79% for MACOP-B and other regimens, and 75% for HDS/ABMT. After median follow-ups from attaining CR of 48.5 months for CHOP/CHOP-like regimens, 51.7 months for MACOP-B type regimens and 32.4 months for HDS/ABMT, relapses occurred in 15/64 (23%), 27/218 (12%) and 0/33 (0%) patients, respectively. Projected 10-year progression-free survival rates were 35%, 67% and 78%, respectively (p=0.0000). Projected 10-year overall survival rates were 44%, 71% and 77%, respectively (p=0.0000), after median follow-ups from diagnosis of 52.3 months, 54.9 months and 35.8 months, respectively. INTERPRETATION AND CONCLUSIONS: In patients with PMLBCL with sclerosis, MACOP-B plus radiation therapy may be a better strategy than other treatments; these retrospective data need to be confirmed by prospective studies. The encouraging survival results after high dose chemotherapy require confirmation in selected high-risk patients.}, number={12}, journal={Haematologica}, author={PL Zinzani and M Martelli and M Bertini and AM Gianni and L Devizzi and M Federico and G Pangalis and J Michels and E Zucca and M Cantonetti and S Cortelazzo and A Wotherspoon and AJ Ferreri and F Zaja and F Lauria and A De Renzo and MA Liberati and B Falini and M Balzarotti and A Calderoni and A Zaccaria and P Gentilini and PP Fattori and E Pavone and MK Angelopoulou and L Alinari and M Brugiatelli and N Di Renzo and F Bonifazi and SA Pileri and F Cavalli and International Extranodal Lymphoma Study Group (IELSG)}, year={2002}, month={Dec.}, pages={1258-1264} }