title: [Therapy for primary mediastinal large B-cell lymphoma in accordance with the R-DA-EPOCH-21 program: The first results].
abstract: OBJECTIVE
  to evaluate the efficiency of the R-DA-EPOCH-21 + R-DHAP protocol and autologous hematopoietic stem cell transplantation (a BEAM conditioning mode) in first-line therapy for primary mediastinal large B-cell lymphoma (PMBCL).
  
  
  METHODS
  In 2013 to 2016, the investigation enrolled 57 patients with newly diagnosed PMBCL (according to the 2008 WHO criteria). The results were analyzed in 40 patients who had completed their treatment.
  
  
  RESULTS
  All the 40 patients (14 men and 26 women) (median age, 27 years (19 to 67 years)) received 6 cycles of polychemotherapy (PCT) in accordance with the R-DA-EPOCH-21 regimen. After induction PCT cycles, 32/40 (80%) patients achieved complete remission. Partial remission was stated in 8/40 (20%) patients who had further 2 cycles of chemotherapy using the R-DHAP program and autologous hematopoietic stem cell transplantation (a BEAM conditioning mode). Two-year overall and relapse-free survival rates were 100% and 96%, respectively; the median follow-up was 17 months.
  
  
  CONCLUSIONS
  The R-DA-EPOCH regimen allows complete remission in 80% of the cases and two-year survival in 100%. If there are unfavorable factors at onset and in partial remission, it is appropriate to intensify treatment at early stages, by using high-dose chemotherapy and autologous hematopoietic stem transplantation.
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: Ya K
authors.initials: YK
authors.lastname: Mangasarova
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: A U
authors.initials: AU
authors.lastname: Magomedova
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E S
authors.initials: ES
authors.lastname: Nesterova
authors.affiliation: Tula Regional Clinical Hospital.
authors.forename: E M
authors.initials: EM
authors.lastname: Volodicheva
authors.affiliation: Tula, Russia ,City Clinical Hospital Fifty-Two, Moscow Healthcare Department, Moscow, Russia.
authors.forename: V I
authors.initials: VI
authors.lastname: Vorobyev
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: S K
authors.initials: SK
authors.lastname: Kravchenko
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012074:Remission Induction; D014182:Transplantation, Autologous; D055815:Young Adult