R-CHOP without radiation in frontline management of primary mediastinal B-cell lymphoma

Marcus Messmer, Hua Ling Tsai, Ravi Varadhan, Lode J. Swinnen, Richard J. Jones, Richard F. Ambinder, Satish P. Shanbhag, Michael J. Borowitz, Nina Wagner-Johnston

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation.

Original languageEnglish (US)
Pages (from-to)1261-1265
Number of pages5
JournalLeukemia and Lymphoma
Issue number5
StatePublished - Apr 16 2019


  • Primary mediastinal B-cell lymphoma
  • R-CHOP
  • diffuse large B-cell lymphoma
  • non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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