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Therapeutic results of diffuse large  B-cell lymphoma LNH 2008

Therapeutic results of diffuse large  B-cell lymphoma LNH 2008. Groupe d’Etude des Lymphomes en Tunisie Sousse, 25 th May 2012. Introduction. LNH 2008: third protocol …after LNH 97 and LNH 2002 Between september 2008- august 2011.

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Therapeutic results of diffuse large  B-cell lymphoma LNH 2008

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  1. Therapeutic results of diffuse large  B-cell lymphoma LNH 2008 Groupe d’Etude des Lymphomes en Tunisie Sousse, 25th May 2012

  2. Introduction • LNH 2008: third protocol …after LNH 97 and LNH 2002 • Between september 2008- august 2011

  3. LNH 97 LNH 2002 aa-IPI=0, 16-65y 3CHOP+RT aa-IPI=0, 16-70y aa-IPI=1,2,3 16-55 4 ACVBP+conso aa-IPI=1, 16-60y 4 R-ACVBP+ Auto aa-IPI=2-3,16-60y aa-IPI=1,2,3, 56-65y 8 (R)-CHOP aa-IPI=1,2,3, 61-70y aa-IPI=0, > 65y 4 mini-CEOP+RT aa-IPI=0, > 70y aa-IPI=1,2,3, > 65y 6 CVP or 6 mini-CEOP aa-IPI=1,2,3, > 70y

  4. LNH 2002 OS = 58%

  5. LNH 2002-1 OS = 87 %

  6. LNH 2002-2A OS = 82%

  7. LNH 2002-2B OS = 46%

  8. LNH 2002-3 OS = 52%

  9. LNH 2002-5 OS = 38%

  10. 3d prospective protocol LNH 2008 September 2008- August 2011 Oncology Tunis: 65 patients Hematology Tunis HO: 47 patients Oncology Sousse: 31 patients Hematology+Oncology Sfax: 27 patients Hematology Military: 22 patients Hematology Monastir: 20 patients Hematology Sousse: 17 patients CNGMO

  11. LNH 2008 Risk Stratification Age60 y 70 y

  12. LNH 2008 (16 - 70 y) B, 0 factor B, 1,2,3 factor(s) 16 - 59 y 60 - 70 y 2008-1 2008-2 2008-3 1 factor 2-3 factors 2008-2A 2008-2B 6 R-CHOP 14 8 R-CHOP 21 4 R-ACVBP + PBSCT 8 R-CHOP 14 Prognostic Factors : LDH > 1N ; Stage III, IV ; PS > 2

  13. LNH 2008(> 70 y) B, 71-75 y , PS<2 0, 1, 2 factor(s) B >75 y or B, 71-75 PS > 2, 1,2,3 factor(s) 2008-5 2008-4 6 R-CHOP 21 6 mini CEOP Prognostic Factors : LDH > 1N ; Stage III, IV ; PS > 2

  14. Patient’ characteristics Age: 54 y (16-86y) Gender: M: 136 sex-ratio: 1.46 F: 93 6 groups: LNH 2008-1: 60 patients LNH 2008-2A: 50 patients LNH 2008-2B: 51 patients LNH 2008-3: 23 patients LNH 2008-4: 13 patients LNH 2008-5: 32 patients

  15. Sites at diagnosis

  16. Sites at diagnosis

  17. Sites at diagnosis

  18. Localisation

  19. Localisation

  20. Localisation

  21. Pronostic factors

  22. Pronostic factors

  23. Response

  24. Response

  25. Response

  26. Response LNH 2008-2B CR+PR: 32 patients Auto: 23 patients

  27. Toxicity

  28. Toxicity

  29. Relapse (18 patients)

  30. Relapse (18 patients)

  31. Final Assessment (median follow-up:18 months)

  32. Final Assessment

  33. Final Assessment

  34. LNH 2008 OS = 75%

  35. LNH 2008 EFS = 69%

  36. LNH 2008-1 OS = 93%

  37. LNH 2008-1 EFS = 90%

  38. LNH 2008-2A OS = 79%

  39. LNH 2008-2A EFS = 71%

  40. LNH 2008-2B OS = 67%

  41. LNH 2008-2B EFS = 59%

  42. LNH 2008-3 OS = 62%

  43. LNH 2008-3 EFS = 54%

  44. LNH 2008-4 OS = 63%

  45. LNH 2008-4 EFS = 41%

  46. LNH 2008-5 OS = 56%

  47. LNH 2008-5 EFS = 61%

  48. Conclusions LNH 2008-1: 6 R-CHOP14 is a good option (CHOP+RT) LNH 2008-2A: 8 R-CHOP14 / 4 R-ACVBP+conso LNH 2008-2B: 4 R-ACVBP toxicity++ PBSCT is the standard LNH 2008-3: 8 R-CHOP 21 +++ LNH 2008-4: testing for treatment of elderly patients with CHOP (EFS < 2008-5) LNH 2008-5: 6 R-miniCEOP

  49. ACKNOWLEDGEMENTS All the members of GELT Ben Lakhal Raihane Ben Othman Tarek Elloumi Moez Gharbi Olfa Mezlini Amel Msadek Fehmi Toumi Nabil Zahra Kmira Laatiri M. Adnène

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