Primary Mediastinal Large B-cell Lymphoma : Impact of Chemotherapy Choice

Hematol Oncol Stem Cell Ther. 2022 Dec 23;15(4):196-200. doi: 10.1016/j.hemonc.2021.05.002.


Objective/background: Data generated from retrospective studies on primary mediastinal B-cell lymphoma (PMBCL) outcome are valuable as no prospective phase 3 trials have been conducted in this rare type of lymphoma.

Methods: Our goal was to assess the long-term outcome of 41 patients with PMBCL who were treated at the Kuwait Cancer Center. We evaluated two types of multidrug treatment, R-CHOP (rituximab, vincristine, doxorubicin, cyclophosphamide, and prednisone) and DA-EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab), and determined overall survival and complete response (CR) as primary endpoints.

Results: In our cohort, 27 (66%) cases were treated with R-CHOP and 14 (34%) cases were treated with DA-EPOCH-R. The overall median follow-up time was 34 months. Among the patients treated with R-CHOP, 23 out of 27 (92.6%) patients achieved CR; similarly, 10 out of 14 patients (85.7%) in the DA-EPOCH-R group achieved CR after initial treatment. There were no differences in OS between patients treated with R-CHOP versus DA-EPOCH-R.

Conclusion: The findings of this study indicate that combined chemotherapy and immunotherapy results in excellent long-term outcome of patients with PMBCL. At our center, we prefer R-CHOP to DA-EPOCH-R for low-risk patients with nonbulky disease.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Cyclophosphamide
  • Doxorubicin
  • Humans
  • Lymphoma, Large B-Cell, Diffuse*
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Rituximab / therapeutic use
  • Treatment Outcome
  • Vincristine / therapeutic use


  • Rituximab
  • Prednisone
  • Vincristine
  • Cyclophosphamide
  • Doxorubicin