Combination of rituximab with autologous peripheral blood stem cell transplantation for treatment of diffuse large B-cell lymphoma: a single-center experience.
- Author:
Ze-yin LIANG
1
;
Xi-nan CEN
;
Zhi-xiang QIU
;
Jin-ping OU
;
Wen-sheng WANG
;
Wei-lin XU
;
Yuan LI
;
Mang-ju WANG
;
Yu-jun DONG
;
Li-hong WANG
;
Yue YIN
;
Yu-hua SUN
;
Wei LIU
;
Qian WANG
;
Han-yun REN
Author Information
- Publication Type:Clinical Trial
- MeSH: Adolescent; Adult; Aged; Antibodies, Monoclonal, Murine-Derived; therapeutic use; Combined Modality Therapy; Female; Humans; Lymphoma, Large B-Cell, Diffuse; therapy; Male; Middle Aged; Peripheral Blood Stem Cell Transplantation; Rituximab; Transplantation, Autologous; Young Adult
- From: Chinese Journal of Hematology 2012;33(12):1033-1037
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVEThis study was aimed to investigate whether incorporation of rituximab into high-dose chemotherapy with autologous peripheral blood stem cell transplantation (auto-PBSCT)could improve the survival of patients with diffuse large B-cell lymphoma (DLBCL), and evaluate the safety of this regimen.
METHODSTwenty-five patients (age, 17 - 61 yrs) with DLBCL were treated with a sequential chemotherapy for remission induction, intensive chemotherapy for mobilization of stem cells, and high-dose chemotherapy followed by auto-PBSCT. Among 25 patients, 22 cases were at IV Ann Arbor stage, 60% cases with B symptom, and 10 cases with intermediate-high risk and 2 cases with high risk when evaluated by International Prognostic Index (IPI). The high-dose chemotherapy included BEAM regimen for 21 patients, and TBI conditioning regimen for 4 patients. Each patient received infusion of rituximab at a dose of 375 mg/m(2) for 2 times, each at peripheral blood stem cell mobilization and peripheral stem cell infusion.
RESULTS20 patients achieved complete remission (CR) before transplantation. After high-dose chemotherapy and auto-PBSCT, 92% patients achieved CR. At a median follow-up of 45 months, the estimated 3-year overall survival (OS) and progression-free survival (PFS) were 78.9% and 75.9%, respectively, for all patients; while those were 87.4% and 82.4% for patients achieved CR before auto-PBSCT. Multivariate analysis by Cox regression revealed that failure to achieving CR before auto-PBSCT was an independent prognostic factor affecting OS, while factor affecting PFS was IPI scores. Rituximab was generally well tolerated with few side-effects.
CONCLUSIONOur results suggested that the addition of rituximab to high-dose chemotherapy followed by auto-PBSCT was effective and safe for patients with DLBCL.