Objective: To evaluate the therapeutic effectiveness and safety of high dose chemoradiotherapy (HDC) combined with autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of patients with primary large mediastinal B-cell lymphoma (PMLBL).
Methods: Among nine patients with PMLBL treated with APBSCT, high dose chemotherapy combined with total body irradiation (TBI) or total lymph node irradiation (TLI)/subtotal lymph node irradiation (STLI) were given to 7 patients and high dose chemotherapy only as pre-transplantation regimen in 2 patients. All patients received supplementary irradiation at the primary mediastinum after transplantation.
Results: After a median follow-up of 24 (10 - 84) months, 5 patients achieved complete remission (CR) and 3 patients partial remission (PR) after induction chemotherapy. One patient developed progressive disease before transplantation. All 5 patients who achieved CR after induction chemotherapy became disease-free survivors (DFS). One of 3 patients who achieved PR after induction chemotherapy was DFS, the other two died in the third and fifth month, respectively. The patient who relapsed before transplantation died in the sixth month carrying the disease all along. According to the life table method, the cumulative probability of 7-year DFS and overall survival (OS) were both 66.7%. No transplant-related mortality was found.
Conclusion: High dose chemoradiotherapy combined with autologous peripheral blood stem cell transplantation is a highly potential therapeutic treatment for poor prognostic primary mediastinal large B-cell lymphoma.