Outcomes of Autologous stem cell transplantation in patients with primary refractory Diffuse Large B-cell lymphoma who demonstrate chemosensitivity to salvage chemotherapy

M. Rauf, I. Maghfoor, Muhammad Aseafan, Khadijah Al Shankati, Ali M. Alhanash, Faateh Sohail, Tusneem A. M. Elhassan, S. Akhtar
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Abstract

Rituximab with anthracycline-based combination frontline chemoimmunotherapy can cure 50–60% of patients with diffuse large B-cell lymphoma (DLBCL). However, studies on the outcomes of patients with DLBCL who experience partial response (PR), stable or progressive disease in response to frontline rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) therapy are limited, as are data on the outcomes of high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) in patients with primary refractory DLBCL who demonstrate chemosensitivity to salvage chemotherapy (SC). We assessed the latter among 184 patients, 144 of whom started SC, with 84 responding and 72 receiving HDC–ASCT. The 5-year survival rate was 58.9%; the median overall survival (OS) was not reached. The difference in response to SC (partial response versus complete response) was significant, with higher 2- and 5-year OS rates in patients with CR (78.1% and 74.9%, respectively) than in those with PR (55.3% and 47%, respectively). The median OS for the whole group was 15 months and particularly patients who had progressive disease after frontline R-CHOP had dismal outcomes. Our study suggests that in patients with primary refractory DLBCL without initial progressive disease after frontline R-CHOP, the depth of response to SC before HDC–ASCT is predictive of relapse.
对挽救性化疗化疗敏感的原发性难治性弥漫大B细胞淋巴瘤患者进行自体干细胞移植的疗效
利妥昔单抗与蒽环类药物联合一线化疗免疫疗法可治愈50%-60%的弥漫大B细胞淋巴瘤(DLBCL)患者。然而,对接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松(RCHOP)一线疗法后出现部分反应(PR)、病情稳定或进展的DLBCL患者疗效的研究很有限,而对对挽救性化疗(SC)化疗敏感的原发性难治性DLBCL患者进行大剂量化疗(HDC)和自体干细胞移植(ASCT)疗效的研究数据也很有限。我们对184名患者进行了评估,其中144人开始接受挽救化疗,84人有反应,72人接受了HDC-ASCT。5年生存率为58.9%;总生存期(OS)中位数未达到。对SC的反应(部分反应与完全反应)差异显著,CR患者的2年和5年OS率(分别为78.1%和74.9%)高于PR患者(分别为55.3%和47%)。全组患者的中位生存期为15个月,尤其是在前线R-CHOP治疗后病情进展的患者,生存期更短。我们的研究表明,对于在前线R-CHOP治疗后无初始进展性疾病的原发性难治性DLBCL患者,HDC-ASCT前对SC的反应深度可预测复发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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