{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:12:07Z","timestamp":1789567927546,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,1,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Salvage immunochemotherapy followed by high\u2010dose chemotherapy and autologous stem cell transplantation is the standard\u2010of\u2010care second\u2010line treatment for patients with relapsed\/refractory diffuse large B\u2010cell lymphoma after first\u2010line R\u2010CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Outcomes after receipt of second\u2010line immunochemotherapy in patients with aggressive B\u2010cell lymphomas who relapse or are refractory to intensive first\u2010line immunochemotherapy regimens (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab [R\u2010EPOCH], rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with methotrexate and cytarabine [R\u2010HyperCVAD], rituximab, cyclophosphamide, vincristine, doxorubicin, and high\u2010dose methotrexate alternating with ifosfamide, etoposide, and cytarabine [R\u2010CODOX\u2010M\/IVAC]) remain unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcomes of patients with non\u2010Burkitt, aggressive B\u2010cell lymphomas and relapsed\/refractory disease after first\u2010line treatment with intensive immunochemotherapy regimens who received platinum\u2010based second\u2010line immunochemotherapy were reviewed retrospectively. Analyses were performed to determine progression\u2010free survival (PFS) and overall survival (OS) from the time of receipt of second\u2010line immunochemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 195 patients from 19 academic centers were included in the study. The overall response rate to second\u2010line immunochemotherapy was 44%, with a median PFS of 3\u00a0months and a median OS of 8\u00a0months. Patients with early treatment failure (primary refractory or relapse &lt;12\u00a0months from completion of first\u2010line therapy) experienced inferior median PFS (2.8 vs 23\u00a0months; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and OS (6\u00a0months vs not reached; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) compared with patients with late treatment failure. Although the 17% of patients with early failure who achieved a complete response to second\u2010line immunochemotherapy experienced prolonged survival, this outcome could not be predicted by clinicopathologic features at the start of second\u2010line immunochemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with early treatment failure after intensive first\u2010line immunochemotherapy experience poor outcomes after receiving standard second\u2010line immunochemotherapy. The use of standard\u2010of\u2010care or experimental therapies currently available in the third\u2010line setting and beyond should be investigated in the second\u2010line setting for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.32526","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T01:17:48Z","timestamp":1569892668000},"page":"293-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Outcomes in patients with aggressive B\u2010cell non\u2010Hodgkin lymphoma after intensive frontline treatment failure"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3748-4507","authenticated-orcid":false,"given":"Emily C.","family":"Ayers","sequence":"first","affiliation":[{"name":"Abramson Cancer Center University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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