Dose-enhanced immunochemotherapy followed by first-line autologous peripheral blood stem cell transplantation for young patients with high-risk aggressive B-cell lymphoma: an efficacy and prognostic factor analysis.
10.3760/cma.j.issn.0253-2727.2022.03.006
- Author:
Yi WANG
1
;
Wei LIU
1
;
Wen Yang HUANG
1
;
Rui LYU
1
;
Jian LI
1
;
Shu Hui DENG
1
;
Wei Wei SUI
1
;
Hong LIU
1
;
Ting Yu WANG
1
;
Shu Hua YI
1
;
Hui Min LIU
1
;
Lu Gui QIU
1
;
De Hui ZOU
1
Author Information
1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
- Publication Type:Journal Article
- Keywords:
Antineoplastic combined chemotherapy protocols;
Lymphoma, B-cell;
Peripheral blood stem cell transplantation
- MeSH:
Adult;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Disease-Free Survival;
Hematopoietic Stem Cell Transplantation;
Humans;
Lymphoma, B-Cell;
Peripheral Blood Stem Cell Transplantation;
Prognosis;
Retrospective Studies;
Stem Cell Transplantation;
Transplantation, Autologous
- From:
Chinese Journal of Hematology
2022;43(3):215-220
- CountryChina
- Language:Chinese
-
Abstract:
Objective: This study aimed to determine the efficacy of dose-enhanced immunochemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT) in young patients with newly diagnosed high-risk aggressive B-cell lymphoma. Methods: A retrospective study was conducted to examine the clinical and survival data of young patients with high-risk aggressive B-cell lymphoma who received dose-enhanced immunochemotherapy and ASCT as first-line treatment between January 2011 and December 2018 in Blood Diseases Hospital. Results: A total of 63 patients were included in the study. The median age range was 40 (14-63) years old. In terms of the induction therapy regimen, 52 cases received R-DA-EP (D) OCH, and the remaining 11 received R-HyperCVAD/R-MA. Sixteen (25.4% ) patients achieved partial response in the mid-term efficacy assessment, and ten of them were evaluated as complete response after transplantation. The median follow-up was 50 (8-112) months, and the 3-year progression-free survival (PFS) rate and overall survival (OS) rate were (83.9±4.7) % and (90.4±3.7) % , respectively. Univariate analysis demonstrated that age-adjusted international prognostic index ≥2 scores was a negative prognostic factor for OS (P=0.039) , and bone marrow involvement (BMI) was an adverse prognostic factor for OS (P<0.001) and PFS (P=0.001) . However, multivariate analysis confirmed that BMI was the only independent negative predictor of OS (P=0.016) and PFS (P=0.001) . Conclusions: The use of dose-enhanced immunochemotherapy in combination with ASCT as first-line therapy in the treatment of young, high-risk aggressive B-cell lymphoma results in good long-term outcomes, and BMI remains an adverse prognostic factor.
