TY - JOUR
T1 - High-Dose Therapy and Autologous Stem Cell Transplantation in First Relapse for Diffuse Large B Cell Lymphoma in the Rituximab Era
T2 - An Analysis Based on Data from the European Blood and Marrow Transplantation Registry
AU - Mounier, Nicolas
AU - Canals, Carmen
AU - Gisselbrecht, Christian
AU - Cornelissen, Jan
AU - Foa, Roberto
AU - Conde, Eulogio
AU - Maertens, John
AU - Attal, Michel
AU - Rambaldi, Alessandro
AU - Crawley, Charles
AU - Luan, Jian-Jian
AU - Brune, Mats
AU - Wittnebel, Sebastian
AU - Cook, Gordon
AU - van Imhoff, G. W.
AU - Pfreundschuh, Michael
AU - Sureda, Anna
AU - Lymphoma Working Party European
PY - 2012/5
Y1 - 2012/5
N2 - Autologous stem cell transplantation (ASCT) consolidation remains the treatment of choice for patients with relapsed diffuse large B cell lymphoma. The impact of rituximab combined with chemotherapy in either first- or second-line therapy on the ultimate results of ASCT remains to be determined, however. This study was designed to evaluate the benefit of ASCT in patients achieving a second complete remission after salvage chemotherapy by retrospectively comparing the disease-free survival (DFS) after ASCT for each patient with the duration of the first complete remission (CRI). Between 1990 and 2005, a total of 470 patients who had undergone ASCT and reported to the European Blood and Bone Transplantation Registry with Medical Essential Data Form B information were evaluated. Of these 470 patients, 351(74%) had not received rituximab before ASCT, and 119 (25%) had received rituximab before ASCT. The median duration of CRI was 11 months. The median time from diagnosis to ASCT was 24 months. The BEAM protocol was the most frequently used conditioning regimen (67%). After ASCT, the 5-year overall survival was 63% (95% confidence interval, 58%-67%) and 5-year DFS was 48% (95% confidence interval, 43%-53%) for the entire patient population. Statistical analysis showed a significant increase in DFS after ASCT compared with duration of CRI (median, 51 months versus 11 months; P <.001). This difference was also highly significant for patients with previous exposure to rituximab (median, 10 months versus not reached; P <.001) and for patients who had experienced relapse before 1 year (median, 6 months versus 47 months; P <.001). Our data indicate that ASCT can significantly increase DFS compared with the duration of CRI in relapsed diffuse large B cell lymphoma and can alter the disease course even in patients with high-risk disease previously treated with rituximab. Biol Blood Marrow Transplant 18: 788-793 (2012) (C) 2012 American Society fir Blood and Marrow Transplantation
AB - Autologous stem cell transplantation (ASCT) consolidation remains the treatment of choice for patients with relapsed diffuse large B cell lymphoma. The impact of rituximab combined with chemotherapy in either first- or second-line therapy on the ultimate results of ASCT remains to be determined, however. This study was designed to evaluate the benefit of ASCT in patients achieving a second complete remission after salvage chemotherapy by retrospectively comparing the disease-free survival (DFS) after ASCT for each patient with the duration of the first complete remission (CRI). Between 1990 and 2005, a total of 470 patients who had undergone ASCT and reported to the European Blood and Bone Transplantation Registry with Medical Essential Data Form B information were evaluated. Of these 470 patients, 351(74%) had not received rituximab before ASCT, and 119 (25%) had received rituximab before ASCT. The median duration of CRI was 11 months. The median time from diagnosis to ASCT was 24 months. The BEAM protocol was the most frequently used conditioning regimen (67%). After ASCT, the 5-year overall survival was 63% (95% confidence interval, 58%-67%) and 5-year DFS was 48% (95% confidence interval, 43%-53%) for the entire patient population. Statistical analysis showed a significant increase in DFS after ASCT compared with duration of CRI (median, 51 months versus 11 months; P <.001). This difference was also highly significant for patients with previous exposure to rituximab (median, 10 months versus not reached; P <.001) and for patients who had experienced relapse before 1 year (median, 6 months versus 47 months; P <.001). Our data indicate that ASCT can significantly increase DFS compared with the duration of CRI in relapsed diffuse large B cell lymphoma and can alter the disease course even in patients with high-risk disease previously treated with rituximab. Biol Blood Marrow Transplant 18: 788-793 (2012) (C) 2012 American Society fir Blood and Marrow Transplantation
KW - Stem cell transplantation
KW - Aggressive B cell lymphoma
KW - Anti CD20 monoclonal antibody
KW - CHEMOTHERAPY
KW - TRIAL
KW - CHOP
U2 - 10.1016/j.bbmt.2011.10.010
DO - 10.1016/j.bbmt.2011.10.010
M3 - Article
SN - 1083-8791
VL - 18
SP - 788
EP - 793
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -