Diffuse Large B-Cell Lymphoma
Conditions
Keywords
DLBCL, R-DA-EPOCH-21, R-mNHL-BFM-90, auto-SCT
Brief summary
Purpose: to evaluate an efficacy of chemotherapy regimens R-DA-EPOCH-21 and R-mNHL-BFM-90 with and without autologous hematopoietic stem cells transplantation (auto-SCT) in newly diagnosed patients with DLBCL with intermediate and high risk.
Detailed description
Patients initially are randomized into 4 arms: 1. st arm R-DA-EPOCH-21 2. nd arm R-mNHL-BFM-90 3. rd arm R-DA-EPOCH-21 + auto-SCT 4. th arm of R-mNHL-BFM-90 + auto-SCT Patients who achieved complete remission after 6 cycles of R-DA-EPOCH-21 or R-mNHL-BFM-90 immunochemotherapy continue to be under observation (1st and 2nd arms) or continue treatment with Rituximab + BCNU+Etoposid+Ara-C+Melphalan (R-BEAM) followed by auto-SCT (3rd and 4th arms). Patients who achieved partial remission after 6 cycles of R-DA-EPOCH-21 or R-mNHL-BFM-90 immunochemotherapy continue treatment with 2 cycles of Rituximab+Dexamethasone+Ara-C+Cisplatin (R-DHAP), continue to be under observation (1st and 2nd arms) or continue treatment with R-BEAM, followed by auto-SCT (3rd and 4th arms).
Interventions
DRUGR-DA-EPOCH-21
R-DA-EPOCH-21 treatment without auto-SCT for DLBCL patients younger than 60 years with intermediate and high risk for IPI
R-DA-EPOCH-21 treatment with auto-SCT for DLBCL patients younger than 60 years with intermediate and high risk for IPI
DRUGR-mNHL-BFM-90
R-mNHL-BFM-90 without auto-SCT in patients with DLBCL under the age of 60 years with intermediate and high risk for IPI
DRUGR-mNHL-BFM-90 + auto-SCT
R-mNHL-BFM-90 with auto-SCT in patients with DLBCL under the age of 60 years with intermediate and high risk for IPI
Sponsors
National Research Center for Hematology
National Research Center for Hematology, Russia
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Newly diagnosed DLBCL, 2. No previous treatment with chemotherapy and/or radiation therapy of DLBCL 3. Presence of 2 or more signs of unfavorable prognosis (IPI 2-4) 4. Age 18-60 years.
Exclusion criteria
1. Transformation of mature cell lymphomas in DLBCL. 2. B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Hodgkin's lymphoma 3. B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma 4. DLBCL of central nervous system (CNS) 5. testicular DLBCL 6. Primary mediastinal large B-cell lymphoma 7. Pretreated DLBCL. 8. HIV-associated DLBCL 9. Congestive heart failure, unstable angina, severe cardiac arrhythmias and conduction disturbances, myocardial infarction. 10. Renal insufficiency (serum creatinine greater than 0.2 mmol/L) (except cases with specific kidney infiltration, urinary tract compression by tumor conglomerate or presence of uric acid nephropathy due to massive cytolysis syndrome). 11. Liver failure (except cases with liver tumor infiltration), acute hepatitis or active phase of chronic hepatitis B or C with serum bilirubin greater than 1.5 standards, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) greater than 3 standards, prothrombin index less than 70%. 12. Severe pneumonia (except cases with specific lungs infiltration), accompanied by respiratory failure (dyspnea \> 30 in min., hypoxemia less than 70 mm Hg, when it is impossible to compensate situation in 2-3 days). 13. Life-threatening bleeding (gastrointestinal, intracranial), with exception of bleeding due to tumor infiltration of organs (stomach, intestines, uterus, etc.) and disseminated intravascular coagulation due to underlying disease complications after their successful conservative treatment. 14. Severe mental disorders (delusions, severe depressive syndrome and other manifestations of productive symptoms) not related with specific infiltration of central nervous system. 15. Decompensated diabetes. 16. Pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| complete response | 168 day | (physical examination, standard blood tests, including assessment of LDH level, thoracic and abdominal computerized tomography (together with any other anatomic site, as clinically indicated), bone marrow biopsy in case of bone marrow involvement and 18F-fludeoxyglucose positron emission tomography (18FDG-PET) (not mandatory) in case of residual measurable disease at the end of the chemoimmunotherapy). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| overall survival | Five-year survival | Survival time and time to disease progression are calculated in months from day of enrollment in the study until death, relapse, progression, or last follow-up, as appropriate |
| disease-free survival | Five-year survival | Survival time and time to disease progression are calculated in months from day of enrollment in the study until death, relapse, progression, or last follow-up, as appropriate |
| event-free survival | Five-year survival | Survival time and time to disease progression are calculated in months from day of enrollment in the study until death, relapse, progression, or last follow-up, as appropriate |
Countries
Russia
Contacts
Primary ContactAminat Magomedova, MD, PhD
Backup ContactSergay Kravchenko, MD PhD
Outcome results
None listed