Outcomes of T-cell/histiocyte-rich large B-cell lymphoma treated with higher-intensity therapy in the rituximab era: insights from a retrospective analysis

Abstract

T-cell/histiocyte-rich B-cell lymphoma (THRLBCL) is an uncommon variant of diffuse large B-cell lymphoma (DLBCL). Historically, it is considered an aggressive variant with poorer outcomes; however, recent analyses suggest that outcomes may be better for patients treated in the rituximab era. We reviewed THRLBCL cases who were diagnosed in MSKCC from January 2000 to October 2019. A total of 67 patients were included with a median follow-up of 5.4 years (0.5-13.8). Frontline treatment included R-CHOP or R-CHOP-based treatment in 48%, R-EPOCH in 12%, R-CHOP/R-ICE in 33% and other palliative treatments in 7.5%. In the whole cohort, 5-year EFS and OS was 59% and 79%, respectively. In an analysis of patients who received therapy with R-CHOP-14 × 4 followed by ICE/R-ICE × 3 compared to patients who were treated with R-CHOP or R-CHOP based treatment, CR rates were 95% and 70%, respectively (p = 0.023). The R-CHOP/R-ICE regimen was also associated with higher event-free survival (5-year EFS of 80% vs 50%; p = 0.006) and overall survival (5-year OS of 100% vs 72%; p = 0013). Our study demonstrates better outcomes among patients with THRLBCL compared to historical data. Our findings suggest that treatment with a higher intensity regimen with noncross resistance, such as R-CHOP/R-ICE is reasonable approach for patients with newly diagnosed THRLBCL.

Keywords: R-CHOP; Rchop/R-ICE; Rituximab; T-cell/histiocyte-rich B-cell lymphoma; diffuse large B‐cell lymphoma.