High-dose Chemotherapy Combined with Autologous Hematopoietic Stem Cell Transplantation as Frontline Therapy for Intermediate/High-risk Diffuse Large B Cell Lymphoma

• Published in: Current medical science 2021-06, Vol.41 (3), p.465-473
• Main Authors: Wen, Qin, Gao, Li, Xiong, Jing-kang, Li, Qiong, Wang, San-bin, Wang, Ji-shi, Liu, Fang, Zhang, Cheng, Liu, Yao, Kong, Pei-yan, Peng, Xian-gui, Rao, Jun, Gao, Lei, Zhang, Xi
• Format: Article
• Language: English
• Subjects: Adult; Combined Modality Therapy; Disease-Free Survival; Dose-Response Relationship, Drug; Drug Therapy - methods; Female; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large B-Cell, Diffuse - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Prognosis; Young Adult
• ISSN: 2096-5230; 2523-899X
• DOI: 10.1007/s11596-021-2394-2

Summary The role of autologous hematopoietic stem cell transplantation (auto-HSCT) following high-dose chemotherapy has been validated and accepted as a standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL). However, its clinical efficacy as frontline therapy remains to be elucidated. This study aimed to examine the feasibility of frontline auto-HSCT for newly diagnosed intermediate/high-risk DLBCL patients. We retrospectively reviewed the data of 223 patients treated with frontline auto-HSCT or chemotherapy alone (year 2008–2014) from four hospitals. The median follow-up time was 29.4 months. Between the two treatment arms among the intermediate/high-risk DLBCL patients, the 3-year overall survival (OS) and progression-free survival (PFS) rates of patients given frontline auto-HSCT were 87.6% and 81.9%, respectively, and the chemotherapy-alone group showed 3-year OS and PFS rates of 64.9% and 59.59%, respectively. Compared with the chemotherapy-alone group, the frontline auto-HSCT could eliminate the adverse impact of non-germinal center B-cell (GCB) type. In addition, in the frontline auto-HSCT group, patients who achieved complete response (CR) at auto-HSCT had a longer survival time than those who did not achieve CR. Our results suggested that frontline auto-HSCT could improve the prognosis of intermediate/high-risk DLBCL patients.