Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis

Adam M. Petrich, Mitul Gandhi, Borko Jovanovic, Jorge J. Castillo, Saurabh Rajguru, David T. Yang, Khushboo A. Shah, Jeremy D. Whyman, Frederick Lansigan, Francisco J. Hernandez-Ilizaliturri, Lisa X. Lee, Stefan K. Barta, Shruthi Melinamani, Reem Karmali, Camille Adeimy, Scott Smith, Neil Dalal, Chadi Nabhan, David Peace, Julie Marie VoseAndrew M. Evens, Namrata Shah, Timothy S. Fenske, Andrew D. Zelenetz, Daniel J. Landsburg, Christina Howlett, Anthony Mato, Michael Jaglal, Julio C. Chavez, Judy P. Tsai, Nishitha Reddy, Shaoying Li, Caitlin Handler, Christopher R. Flowers, Jonathon B. Cohen, Kristie A. Blum, Kevin Song, Haowei Sun, Oliver Press, Ryan Cassaday, Jesse Jaso, L. Jeffrey Medeiros, Aliyah R. Sohani, Jeremy S. Abramson

Research output: Contribution to journalArticle

199 Citations (Scopus)

Abstract

Patients with double-hit lymphoma (DHL), which is characterized by rearrangements of MYC and either BCL2 or BCL6, face poor prognoses. We conducted a retrospective multicenter study of the impact of baseline clinical factors, induction therapy, and stem cell transplant (SCT) on the outcomes of 311 patients with previously untreated DHL. At median follow-up of 23 months, the median progression-free survival (PFS) and overall survival (OS) rates among all patients were 10.9 and 21.9 months, respectively. Forty percent of patients remain disease-free and 49% remain alive at 2 years. Intensive induction was associated with improved PFS, but not OS, and SCT was not associated with improved OS among patients achieving first complete remission (P 5 .14). By multivariate analysis, advanced stage, central nervous system involvement, leukocytosis, and LDH >3 times the upper limit of normal were associated with higher risk of death. Correcting for these, intensive induction was associated with improved OS. We developed a novel risk score for DHL, which divides patients into high-, intermediate-, and low-risk groups. In conclusion, a subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed.

Original languageEnglish (US)
Pages (from-to)2354-2361
Number of pages8
JournalBlood
Volume124
Issue number15
DOIs
StatePublished - Oct 9 2014

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Transplants
Stem Cell Transplantation
Stem cells
Lymphoma
Neurology
Set theory
Stem Cells
Disease-Free Survival
Survival
Leukocytosis
Multicenter Studies
Multivariate Analysis
Survival Rate
Central Nervous System
Retrospective Studies

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Petrich, A. M., Gandhi, M., Jovanovic, B., Castillo, J. J., Rajguru, S., Yang, D. T., ... Abramson, J. S. (2014). Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis. Blood, 124(15), 2354-2361. https://doi.org/10.1182/blood-2014-05-578963

Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma : A multicenter retrospective analysis. / Petrich, Adam M.; Gandhi, Mitul; Jovanovic, Borko; Castillo, Jorge J.; Rajguru, Saurabh; Yang, David T.; Shah, Khushboo A.; Whyman, Jeremy D.; Lansigan, Frederick; Hernandez-Ilizaliturri, Francisco J.; Lee, Lisa X.; Barta, Stefan K.; Melinamani, Shruthi; Karmali, Reem; Adeimy, Camille; Smith, Scott; Dalal, Neil; Nabhan, Chadi; Peace, David; Vose, Julie Marie; Evens, Andrew M.; Shah, Namrata; Fenske, Timothy S.; Zelenetz, Andrew D.; Landsburg, Daniel J.; Howlett, Christina; Mato, Anthony; Jaglal, Michael; Chavez, Julio C.; Tsai, Judy P.; Reddy, Nishitha; Li, Shaoying; Handler, Caitlin; Flowers, Christopher R.; Cohen, Jonathon B.; Blum, Kristie A.; Song, Kevin; Sun, Haowei; Press, Oliver; Cassaday, Ryan; Jaso, Jesse; Medeiros, L. Jeffrey; Sohani, Aliyah R.; Abramson, Jeremy S.

In: Blood, Vol. 124, No. 15, 09.10.2014, p. 2354-2361.

Research output: Contribution to journalArticle

Petrich, AM, Gandhi, M, Jovanovic, B, Castillo, JJ, Rajguru, S, Yang, DT, Shah, KA, Whyman, JD, Lansigan, F, Hernandez-Ilizaliturri, FJ, Lee, LX, Barta, SK, Melinamani, S, Karmali, R, Adeimy, C, Smith, S, Dalal, N, Nabhan, C, Peace, D, Vose, JM, Evens, AM, Shah, N, Fenske, TS, Zelenetz, AD, Landsburg, DJ, Howlett, C, Mato, A, Jaglal, M, Chavez, JC, Tsai, JP, Reddy, N, Li, S, Handler, C, Flowers, CR, Cohen, JB, Blum, KA, Song, K, Sun, H, Press, O, Cassaday, R, Jaso, J, Medeiros, LJ, Sohani, AR & Abramson, JS 2014, 'Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: A multicenter retrospective analysis', Blood, vol. 124, no. 15, pp. 2354-2361. https://doi.org/10.1182/blood-2014-05-578963
Petrich, Adam M. ; Gandhi, Mitul ; Jovanovic, Borko ; Castillo, Jorge J. ; Rajguru, Saurabh ; Yang, David T. ; Shah, Khushboo A. ; Whyman, Jeremy D. ; Lansigan, Frederick ; Hernandez-Ilizaliturri, Francisco J. ; Lee, Lisa X. ; Barta, Stefan K. ; Melinamani, Shruthi ; Karmali, Reem ; Adeimy, Camille ; Smith, Scott ; Dalal, Neil ; Nabhan, Chadi ; Peace, David ; Vose, Julie Marie ; Evens, Andrew M. ; Shah, Namrata ; Fenske, Timothy S. ; Zelenetz, Andrew D. ; Landsburg, Daniel J. ; Howlett, Christina ; Mato, Anthony ; Jaglal, Michael ; Chavez, Julio C. ; Tsai, Judy P. ; Reddy, Nishitha ; Li, Shaoying ; Handler, Caitlin ; Flowers, Christopher R. ; Cohen, Jonathon B. ; Blum, Kristie A. ; Song, Kevin ; Sun, Haowei ; Press, Oliver ; Cassaday, Ryan ; Jaso, Jesse ; Medeiros, L. Jeffrey ; Sohani, Aliyah R. ; Abramson, Jeremy S. / Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma : A multicenter retrospective analysis. In: Blood. 2014 ; Vol. 124, No. 15. pp. 2354-2361.
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abstract = "Patients with double-hit lymphoma (DHL), which is characterized by rearrangements of MYC and either BCL2 or BCL6, face poor prognoses. We conducted a retrospective multicenter study of the impact of baseline clinical factors, induction therapy, and stem cell transplant (SCT) on the outcomes of 311 patients with previously untreated DHL. At median follow-up of 23 months, the median progression-free survival (PFS) and overall survival (OS) rates among all patients were 10.9 and 21.9 months, respectively. Forty percent of patients remain disease-free and 49{\%} remain alive at 2 years. Intensive induction was associated with improved PFS, but not OS, and SCT was not associated with improved OS among patients achieving first complete remission (P 5 .14). By multivariate analysis, advanced stage, central nervous system involvement, leukocytosis, and LDH >3 times the upper limit of normal were associated with higher risk of death. Correcting for these, intensive induction was associated with improved OS. We developed a novel risk score for DHL, which divides patients into high-, intermediate-, and low-risk groups. In conclusion, a subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed.",
author = "Petrich, {Adam M.} and Mitul Gandhi and Borko Jovanovic and Castillo, {Jorge J.} and Saurabh Rajguru and Yang, {David T.} and Shah, {Khushboo A.} and Whyman, {Jeremy D.} and Frederick Lansigan and Hernandez-Ilizaliturri, {Francisco J.} and Lee, {Lisa X.} and Barta, {Stefan K.} and Shruthi Melinamani and Reem Karmali and Camille Adeimy and Scott Smith and Neil Dalal and Chadi Nabhan and David Peace and Vose, {Julie Marie} and Evens, {Andrew M.} and Namrata Shah and Fenske, {Timothy S.} and Zelenetz, {Andrew D.} and Landsburg, {Daniel J.} and Christina Howlett and Anthony Mato and Michael Jaglal and Chavez, {Julio C.} and Tsai, {Judy P.} and Nishitha Reddy and Shaoying Li and Caitlin Handler and Flowers, {Christopher R.} and Cohen, {Jonathon B.} and Blum, {Kristie A.} and Kevin Song and Haowei Sun and Oliver Press and Ryan Cassaday and Jesse Jaso and Medeiros, {L. Jeffrey} and Sohani, {Aliyah R.} and Abramson, {Jeremy S.}",
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T2 - A multicenter retrospective analysis

AU - Petrich, Adam M.

AU - Gandhi, Mitul

AU - Jovanovic, Borko

AU - Castillo, Jorge J.

AU - Rajguru, Saurabh

AU - Yang, David T.

AU - Shah, Khushboo A.

AU - Whyman, Jeremy D.

AU - Lansigan, Frederick

AU - Hernandez-Ilizaliturri, Francisco J.

AU - Lee, Lisa X.

AU - Barta, Stefan K.

AU - Melinamani, Shruthi

AU - Karmali, Reem

AU - Adeimy, Camille

AU - Smith, Scott

AU - Dalal, Neil

AU - Nabhan, Chadi

AU - Peace, David

AU - Vose, Julie Marie

AU - Evens, Andrew M.

AU - Shah, Namrata

AU - Fenske, Timothy S.

AU - Zelenetz, Andrew D.

AU - Landsburg, Daniel J.

AU - Howlett, Christina

AU - Mato, Anthony

AU - Jaglal, Michael

AU - Chavez, Julio C.

AU - Tsai, Judy P.

AU - Reddy, Nishitha

AU - Li, Shaoying

AU - Handler, Caitlin

AU - Flowers, Christopher R.

AU - Cohen, Jonathon B.

AU - Blum, Kristie A.

AU - Song, Kevin

AU - Sun, Haowei

AU - Press, Oliver

AU - Cassaday, Ryan

AU - Jaso, Jesse

AU - Medeiros, L. Jeffrey

AU - Sohani, Aliyah R.

AU - Abramson, Jeremy S.

PY - 2014/10/9

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N2 - Patients with double-hit lymphoma (DHL), which is characterized by rearrangements of MYC and either BCL2 or BCL6, face poor prognoses. We conducted a retrospective multicenter study of the impact of baseline clinical factors, induction therapy, and stem cell transplant (SCT) on the outcomes of 311 patients with previously untreated DHL. At median follow-up of 23 months, the median progression-free survival (PFS) and overall survival (OS) rates among all patients were 10.9 and 21.9 months, respectively. Forty percent of patients remain disease-free and 49% remain alive at 2 years. Intensive induction was associated with improved PFS, but not OS, and SCT was not associated with improved OS among patients achieving first complete remission (P 5 .14). By multivariate analysis, advanced stage, central nervous system involvement, leukocytosis, and LDH >3 times the upper limit of normal were associated with higher risk of death. Correcting for these, intensive induction was associated with improved OS. We developed a novel risk score for DHL, which divides patients into high-, intermediate-, and low-risk groups. In conclusion, a subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed.

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