Skip to Main content Skip to Navigation
Journal articles

Treatment of primary mediastinal large B cell lymphoma with an alternating chemotherapy regimen based on high-dose methotrexate

Abstract : Primary mediastinal large B cell lymphomas (MLCL) differ from other diffuse large cell lymphomas, leading to a description as a separate entity in the current World Health Organization classification. Dose intensification improves long-term results, but no standard therapy has been established so far. We investigated the use of a high-dose methotrexate-based alternating chemotherapy regimen (B-ALL protocol of the German ALL study group) followed by consolidative mediastinal radiotherapy first as a single-center trial, then later as a prospective multicenter trial in 44 patients with a median age of 33 years. Response rates exceeded 90% with an overall survival rate of 80% in the single-center group (8.6 years median follow-up) and 82% in the multicenter group (2.5 years follow-up).Short-term toxicity was manageable, but required hospitalization: the rates of grade 3 or 4 toxicity were 20% (for mucositis), 42% (for neutropenia), 29% (for thrombocytopenia), and 9% (for neutropenic fever). No relapse occurred more than 2 years after diagnosis and initiation of treatment, but unfortunately, no patient with overt progression or relapse within these 2 years could be salvaged. Future directions in the treatment of MLCL will not focus on further dose intensification, but rather on the incorporation of (radio)immunotherapy as a therapeutic tool and gene expression profiling as well as positron emission tomography–computed tomography as stratifying tools.
Document type :
Journal articles
Complete list of metadata

Cited literature [31 references]  Display  Hide  Download
Contributor : Hal Peer Connect in order to contact the contributor
Submitted on : Friday, April 30, 2010 - 2:10:23 PM
Last modification on : Friday, January 8, 2021 - 4:54:06 PM
Long-term archiving on: : Wednesday, November 30, 2016 - 8:33:42 PM


Files produced by the author(s)




T. Fietz, W. U. Knauf, M. Hänel, A. Franke, M. Freund, et al.. Treatment of primary mediastinal large B cell lymphoma with an alternating chemotherapy regimen based on high-dose methotrexate. Annals of Hematology, Springer Verlag, 2008, 88 (5), pp.433-439. ⟨10.1007/s00277-008-0625-2⟩. ⟨hal-00477987⟩



Record views


Files downloads