The CARMEN regimen appears to be effective in patients with MYC-rearranged aggressive lymphoma, including patients who are HIV-positive, according to a retrospective study published in Blood Advances.
The study included 68 patients, 22 of whom had high-grade B-cell lymphoma (HGBCL) and 46 of whom had Burkitt lymphoma (BL). In the HGBCL group, the median age was 55 years, 68% of patients were men, and 41% were HIV-positive. In the BL group, the median age was 45 years, 80% were men, and 80% were HIV-positive.
Patients received the CARMEN regimen — a 36-day induction with sequential, single weekly doses of cyclophosphamide, vincristine, rituximab, methotrexate, etoposide, and doxorubicin plus intrathecal chemotherapy, followed by high-dose cytarabine-based consolidation. All patients who did not achieve a complete response after induction received conditioning with carmustine, etoposide, cytarabine, and melphalan, followed by autologous stem cell transplant.
Overall, 90% of patients completed induction, 87% completed consolidation, and 17 patients underwent transplant. After the full treatment, the complete response rate was 73% in the HGBCL group and 78% in the BL group.
At a median follow-up of 65 months, 15 patients with HGBCL and 33 patients with BL were event-free. The 5-year progression-free survival rate was 70% overall, 63% in the HGBCL group, and 72% in the BL group. The 5-year overall survival rates were 72%, 63%, and 76%, respectively. HIV status did not appear to predict outcomes.
Grade 4 hematologic toxicities were common during induction and consolidation. Grade 4 nonhematologic toxicities occurred in 16% of patients. Six patients (9%) died from toxicity.
“Consistency of the present results with previously reported retrospective and prospective studies lead us to consider the CARMEN treatment as a valid option for HIV− and HIV+ patients with BL,” the study authors wrote. “Promising results in HGBCL and MYC translocation and double-hit lymphoma prompt us to further explore this combination in aggressive B-cell lymphomas.”
Ferreri AJM, Angelillo P, Erbella F, et al. Safety and efficacy of a dose-dense short-term therapy in patients with MYC-translocated aggressive lymphoma. Blood Adv. 2022;6(22):5811-20. doi:10.1182/bloodadvances.2022007475
This article originally appeared on Hematology Advisor