R-CHOP chemoimmunotherapy followed by autologous transplantation for the treatment of diffuse large B-cell lymphoma.
- Author:
Hong Ghi LEE
1
;
Yunsuk CHOI
;
Sung Yong KIM
;
Inho KIM
;
Yeo Kyeoung KIM
;
Yang Soo KIM
;
Ho Sup LEE
;
Seok Jin KIM
;
Jeong A KIM
;
Byeong Bae PARK
;
Jinny PARK
;
Hyeok SHIM
;
Hyeon Seok EOM
;
Junglim LEE
;
Sung Kyu PARK
;
June Won CHEONG
;
Keon Woo PARK
Author Information
- Publication Type:Original Article
- Keywords: Diffuse large B-cell lymphoma; Hematopoietic stem cell transplantation; Autologous transplantation; Rituximab; Survival analysis
- MeSH: Autografts*; Diagnosis; Disease-Free Survival; Electrons; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, B-Cell*; Positron-Emission Tomography and Computed Tomography; Retrospective Studies; Stem Cell Transplantation; Survival Analysis; Transplantation, Autologous*; Rituximab
- From:Blood Research 2014;49(2):107-114
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: We investigated factors that influence outcomes in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab combined with the CHOP regimen (R-CHOP) followed by upfront autologous stem cell transplantation (Auto-SCT). METHODS: We retrospectively evaluated survival differences between subgroups based on the age-adjusted International Prognostic Index (aaIPI) and revised-IPI (R-IPI) at diagnosis, disease status, and positron emission tomographic/computerized tomographic (PET/CT) status at transplantation in 51 CD20-positive DLBCL patients treated with R-CHOP followed by upfront Auto-SCT. RESULTS: Patients had either stage I/II bulky disease (5.9%) or stage III/IV disease (94.1%). The median patient age at diagnosis was 47 years (range, 22-66 years); 53.3% and 26.7% had high-intermediate and high risks according to aaIPI, respectively. At the time of Auto-SCT, 72.5% and 27.5% experienced complete (CR) and partial remission (PR) after R-CHOP, respectively. The median time from diagnosis to Auto-SCT was 7.27 months (range, 3.4-13.4 months). The 5-year overall (OS) and progression-free survival (PFS) were 77.3% and 72.4%, respectively. The 5-year OS and PFS rates according to aaIPI, R-IPI, and PET/CT status did not differ between the subgroups. More importantly, the 5-year OS and PFS rates of the patients who achieved PR at the time of Auto-SCT were not inferior to those of the patients who achieved CR (P=0.223 and 0.292, respectively). CONCLUSION: Survival was not influenced by the aaIPI and R-IPI at diagnosis, disease status, or PET/CT status at transplantation, suggesting that upfront Auto-SCT might overcome unfavorable outcomes attributed to PR after induction chemoimmunotherapy.
