ABCL-435 Management of Primary Mediastinal B-Cell Lymphoma in Morocco: A Monocentric Experience

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2024-09, Vol.24, p.S479-S480
• Main Authors: Chouab, Zineb, Moukrim, Ilham, Qachouh, Meryem, Tlohi, Kawtar, Benmoussa, Amine, Berrada, Sophia, Khoubila, Nisrine, Cherkaoui, Siham, Lamchahab, Mouna, Rachid, Mohamed, Madani, Abdellah
• Format: Article
• Language: English
• Subjects: ABCL; mediastinal lymphoma; outcomes; PMBCL
• ISSN: 2152-2650
• DOI: 10.1016/S2152-2650(24)01529-5

Primary mediastinal B-cell lymphoma (PMBCL) is a distinct clinicopathologic subtype of diffuse large B-cell lymphoma, characterized by a specific epidemiology and clinical course, with distinct histopathological and immunohistochemical features. To describe the epidemiological, clinical, therapeutic and outcomes aspects of patients with PMBCL treated at our department. This retrospective descriptive study was conducted between January 2017 and October 2023 at the Department of Clinical Hematology and Pediatric Oncology, CHU Ibn Rochd. It included patients aged ≥18 years with newly diagnosed PMBCL. The diagnosis of PMBCL was confirmed by histopathological and immunohistochemical analysis based on WHO criteria. Response assessment was done by CT and/or PET scan. Data were collected from patient records and analyzed using Excel version 2020. 45 cases of PMBCL (28 women and 17 men) were included. The median age at diagnosis was 33 years (range, 20-59 years). Clinically, 19 patients (42.2%) presented with superior vena cava syndrome. B symptoms were present in 20 (44.4%). An initial bulky mass ≥10 cm was found in 39 (86.7%) patients. Only 2 patients had bone marrow involvement. The initial PET scan was performed in 14 (31.1%) patients. Most were at stage I/II disease (71.1%). Elevated LDH levels were noted in 33 (73.3%) patients, and an IPI score of 3 to 5 was observed in 15 (33.3%). First-line treatments included: R-CHOP (n=41), R-ACVBP (n=2), R-DAEPOCH (n=2). Complete response was achieved in 34 (75.6%) cases. Six patients received consolidative radiotherapy. Patients who did not respond to induction treatment (n=9, 20%) or relapsed (n=3, 6.7%) received salvage therapy protocols: R-DHAOX (n=7), R-ICE (n=4), and R-DHAP (n=1), with a complete response rate of 33.3%. Only 2 patients underwent autologous stem cell transplantation. Five patients with refractory disease received palliative treatment. The median follow-up period was 18 months, with an overall response rate of 80% and a total of 9 deaths. Our study confirms the efficacy of current PMBCL treatments despite the high mortality rate in our series, underscoring the need for therapeutic approaches that optimize remission while reducing long-term toxicity.