Top Line: What is the radiosensitivity of double hit lymphoma?
The Study: Large B-cell lymphomas with MYC and BCL2 or BCL6 rearrangements (double hit lymphoma) have worse prognosis with higher rates of relapse and worse survival outcomes. However, there is limited data about how DHL responds to radiation. This multicenter, retrospective study collected data from 383 patients who received either curative (55.4%) or palliative intent (44.6%) radiation. Among these, 73.4% had DHL and the rest did not. These patients were heavily pretreated with over a third having chemorefractory disease, and nearly a quarter having prior transplant. The median BED was 28 Gy for palliative cases and 46.9 Gy for curative cases. Among curative cases, the response rate was 81.8%. However, at 1 year, the rate of local recurrence was 31%. Local recurrence was significantly higher among those with DHL (42.9% v 28.9%). Furthermore, PFS was significantly lower among curative cases with DHL. The response rate for palliative cases was 60.1%. Given the refractory nature of the cases in this study, RT resulted in favorable response rates and local control.
TBL: Among heavily pretreated patients with relapsed/refractory large-cell lymphoma, salvage radiation had a >80% response rate and durable local control. However, DHL was associated with nearly double the rate of local recurrence. | Tseng, Int J Radiat Oncol Biol Phys 2024
The Study: Large B-cell lymphomas with MYC and BCL2 or BCL6 rearrangements (double hit lymphoma) have worse prognosis with higher rates of relapse and worse survival outcomes. However, there is limited data about how DHL responds to radiation. This multicenter, retrospective study collected data from 383 patients who received either curative (55.4%) or palliative intent (44.6%) radiation. Among these, 73.4% had DHL and the rest did not. These patients were heavily pretreated with over a third having chemorefractory disease, and nearly a quarter having prior transplant. The median BED was 28 Gy for palliative cases and 46.9 Gy for curative cases. Among curative cases, the response rate was 81.8%. However, at 1 year, the rate of local recurrence was 31%. Local recurrence was significantly higher among those with DHL (42.9% v 28.9%). Furthermore, PFS was significantly lower among curative cases with DHL. The response rate for palliative cases was 60.1%. Given the refractory nature of the cases in this study, RT resulted in favorable response rates and local control.
TBL: Among heavily pretreated patients with relapsed/refractory large-cell lymphoma, salvage radiation had a >80% response rate and durable local control. However, DHL was associated with nearly double the rate of local recurrence. | Tseng, Int J Radiat Oncol Biol Phys 2024