Dose-Adjusted EPOCH-Rituximab Shows Encouraging Results for Patients with Primary Mediastinal B-Cell Lymphoma

Initially recognized in the 1980s, primary mediastinal B-cell lymphoma (PMBCL) is a subtype of diffuse large B-cell lymphoma (DLBCL) arising in the thymus. Representing less than 3% of non-Hodgkin lymphoma cases, PMBCL has a skewed age distribution affecting young adults, especially young women. Historically, patients with PMBCL have been treated with mediastinal radiation following chemotherapy based on evidence that chemotherapy alone was insufficient. Despite the high cure rates with this strategy, mediastinal radiation in young patients can be associated with late adverse effects, including premature cardiovascular disease and secondary cancers.

Researchers from the National Cancer Institute (NCI) and their partner institutions recently completed a phase II study of infusional dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (DA-EPOCH-R) with no mediastinal radiation complement. In 51 patients with a median age of 30 years, of which 59% were women, the overall survival rate was 97% at the median 5-year follow-up. From these results, researchers suggested that DA-EPOCH-R therapy obviated the need for radiotherapy in patients with PMBCL.  

While these results from this phase II study are encouraging, they will need to be confirmed with further research.

Waldenstrom’s Macroglobulinemia Clinical Database Study

The purpose of this study at Weill Cornell Medical College is to learn about what might cause lymphoma, to learn about how lymphoma harms the body, and to learn about treatments for Waldenstrom’s Macroglobulinemia.

This study is open to people being treated for Waldenstrom’s Macroglobulinemia outside of NewYork-Presbyterian/Weill Cornell, but participation would require at least one visit at Weill Cornell.

Waldenstrom’s Macroglobulinemia is a rare type of lymphoma, a disease where one of the white blood cells, the lymphocytes, increases in number more than they should. The lymphocytes in Waldenstrom’s Macroglobulinemia also secrete a protein called IgM. Excess IgM can interfere with the circulation of blood. Investigators at Weill Cornell Medical College and other institutions are collecting information about lymphoma patients and their disease, as well studying their lymphoma cells in the laboratory.

Participants in this study give their permission for the investigators to collect their clinical information for research purposes. In addition, the researchers will store participants’ blood, urine, check swab, bone marrow and/or tumor tissue samples for research studies to be performed now and in the future. In some cases, participants may be asked by their physician to provide additional samples.

By studying the clinical course of lymphoma patients and the lymphoma cells in the laboratory, we hope to learn more about what causes lymphoma. We also hope that information from these studies will help identify new treatments for people with lymphoma.

To find out more about this study please contact June Greenberg, RN at (212) 746-2651 or email June at jdg2002@med.cornell.edu.

The principal investigator of this study is Dr. Peter Martin. Click here to read Dr. Martin’s clinical and research profile.