TY - JOUR
T1 - Outcomes in primary cutaneous diffuse large B-cell lymphoma, leg type
AU - Kraft, Robert M.
AU - Ansell, Stephen M.
AU - Villasboas, Jose C.
AU - Bennani, N. Nora
AU - Wang, Yucai
AU - Habermann, Thomas M.
AU - Thanarajasingam, Gita
AU - Lester, Scott C.
AU - Macon, William
AU - Inwards, David J.
AU - Porrata, Luis F.
AU - Micallef, Ivana N.
AU - Witzig, Thomas E.
AU - Thompson, Carrie A.
AU - Johnston, Patrick B.
AU - Nowakowski, Grzegorz S.
AU - Lin, Yi
AU - Paludo, Jonas
N1 - Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2021/12
Y1 - 2021/12
N2 - Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is a rare, aggressive lymphoma characterized by skin involvement predominantly in the lower extremities. Immunochemotherapy with or without involved-site radiation therapy (ISRT) is considered standard front-line therapy. Over-expression of PD-L1/PD-L2 is seen in a high proportion of PCDLBCL, LT cases, but efficacy of immune checkpoint inhibitors (ICI) in relapsed/refractory, PCDLBCL, LT has not been thoroughly studied. We conducted a retrospective cohort study of patients diagnosed with PCDLBCL, LT seen at Mayo Clinic from 1 January 2000 to 31 December 2020. Using the Kaplan–Meier method, we calculated progression-free survival, duration of response, and overall survival in patients who received front-line rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with and without ISRT, and salvage ICI therapy for relapsed/refractory disease. A total of 28 patients with PCDLBCL, LT were identified. The median PFS in patients treated with R-CHOP plus ISRT was 58 months (95% CI: 18–112) compared to 14 months (95% CI: 5–not reached; p = 0.04) in those treated with R-CHOP without ISRT. The median PFS from salvage ICI therapy was 10 months (95% CI: 4–not reached), and median DOR from salvage ICI therapy was 23 months [95% CI: 4–26]. R-CHOP with ISRT had a significantly longer median PFS compared to R-CHOP without ISRT as front-line therapy for PCDLBCL, LT. ICIs may have a role in treating relapsed/refractory disease as reasonable activity in heavily pre-treated patients was observed in this study.
AB - Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is a rare, aggressive lymphoma characterized by skin involvement predominantly in the lower extremities. Immunochemotherapy with or without involved-site radiation therapy (ISRT) is considered standard front-line therapy. Over-expression of PD-L1/PD-L2 is seen in a high proportion of PCDLBCL, LT cases, but efficacy of immune checkpoint inhibitors (ICI) in relapsed/refractory, PCDLBCL, LT has not been thoroughly studied. We conducted a retrospective cohort study of patients diagnosed with PCDLBCL, LT seen at Mayo Clinic from 1 January 2000 to 31 December 2020. Using the Kaplan–Meier method, we calculated progression-free survival, duration of response, and overall survival in patients who received front-line rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with and without ISRT, and salvage ICI therapy for relapsed/refractory disease. A total of 28 patients with PCDLBCL, LT were identified. The median PFS in patients treated with R-CHOP plus ISRT was 58 months (95% CI: 18–112) compared to 14 months (95% CI: 5–not reached; p = 0.04) in those treated with R-CHOP without ISRT. The median PFS from salvage ICI therapy was 10 months (95% CI: 4–not reached), and median DOR from salvage ICI therapy was 23 months [95% CI: 4–26]. R-CHOP with ISRT had a significantly longer median PFS compared to R-CHOP without ISRT as front-line therapy for PCDLBCL, LT. ICIs may have a role in treating relapsed/refractory disease as reasonable activity in heavily pre-treated patients was observed in this study.
KW - checkpoint inhibitors
KW - cutaneous lymphoma
KW - leg type
UR - http://www.scopus.com/inward/record.url?scp=85113596744&partnerID=8YFLogxK
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U2 - 10.1002/hon.2919
DO - 10.1002/hon.2919
M3 - Article
C2 - 34453851
AN - SCOPUS:85113596744
SN - 0278-0232
VL - 39
SP - 658
EP - 663
JO - Hematological Oncology
JF - Hematological Oncology
IS - 5
ER -