Outcomes of Autologous Hematopoietic Cell Transplantation in Diffuse Large B Cell Lymphoma Refractory to Firstline Chemoimmunotherapy

被引:14
作者
Bal, Susan [1 ]
Costa, Luciano J. [1 ]
Sauter, Craig [2 ,3 ]
Litovich, Carlos [4 ]
Hamadani, Mehdi [4 ,5 ]
机构
[1] Univ Alabama Birmingham, Dept Med, ONeal Comprehens Canc Ctr, Div Hematol & Oncol, Birmingham, AL 35294 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Med, 1275 York Ave, New York, NY 10021 USA
[3] Weill Cornell Med Coll, Dept Med, New York, NY USA
[4] Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
[5] Med Coll Wisconsin, Dept Med, BMT & Cellular Therapy Program, Milwaukee, WI 53226 USA
来源
TRANSPLANTATION AND CELLULAR THERAPY | 2021年 / 27卷 / 01期
基金
美国国家卫生研究院;
关键词
Diffuse large B cell lymphoma; Autologous transplantation; Primary refractory; CHEMOTHERAPY PLUS RITUXIMAB; BONE-MARROW-TRANSPLANTATION; CHOP-LIKE CHEMOTHERAPY; SALVAGE CHEMOTHERAPY; YOUNG-PATIENTS; FEATURES; FAILURE; TRIAL;
D O I
10.1016/j.bbmt.2020.09.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Outcomes of patients with primary refractory diffuse large B cell lymphoma (DLBCL) are dismal. The role of autologous hematopoietic cell transplant (autoHCT) in this population is not well defined in the modern era. Most data sets combine these patients with those with relapsed disease. We report the outcomes of autoHCT in patients with primary refractory DLBCL that subsequently demonstrated chemosensitive disease with salvage therapies, using the Center for International Blood and Marrow Transplant Research registry. Between 2003 and 2018, 169 patients met the inclusion criteria. The median age of the cohort was 54 years, and 64% were male. The patients had advanced stage disease (73%) at diagnosis, 27% patients had stable disease, and 73% had progressive disease after frontline chemoimmunotherapy. Following salvage therapy, 36% patients were in complete remission (CR) and 64% in partial remission (PR). Nonrelapse mortality, progression/relapse, progression-free survival (PFS), and overall survival of this cohort at 4 years were 10.8% (95% confidence interval [CI], 6% to 13%), 47.8% (95% CI, 41% to 52%), 41.4% (95% CI, 38% to 50%), and 49.6% (95% CI, 44% to 56%), respectively. On univariate analysis, patients with progressive disease after frontline chemoimmunotherapy did just as well as those with stable disease. Patients achieving CR with salvage therapy had a lower cumulative incidence of progression/relapse at 1 year (30% versus 46.9%; P =.02) and experienced superior 1-year PFS compared to patients in PR (63.2% versus 46.7%; P =.03). AutoHCT provides durable disease control and should remain the standard of care in patients with primary refractory DLBCL who respond to salvage therapies. (C) 2020 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:55.e1 / 55.e7
页数:7
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