Therapeutic results in patients with relapsed diffuse large B cell Non-Hodgkin's lymphoma achieving complete response only after autologous stem cell transplantation

Forty patients with relapsed diffuse large B cell lymphoma (DLBCL) autografted in partial response (PR) (n = 23) or in refractory relapse (RR) (n = 17) achieved complete remission (CR) after autologous stem cell transplantation (ASCT). Salvage treatment consisted of ifosphamide, epirubicin and etopo...

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Published in:Hematological oncology 2006-06, Vol.24 (2), p.73-77
Main Authors: Ferrara, Felicetto, Viola, Assunta, Copia, Carolina, Schiavone, Ettore Mariano, Celentano, Maria, Pollio, Filiberto, D'Amico, Maria Rosaria, Palmieri, Salvatore
Format: Article
Language:English
Subjects:
autologous transplantation
Disease-Free Survival
Female
Humans
Lymphoma, B-Cell - mortality
Lymphoma, B-Cell - pathology
Lymphoma, B-Cell - therapy
Lymphoma, Large B-Cell, Diffuse - mortality
Lymphoma, Large B-Cell, Diffuse - pathology
Lymphoma, Large B-Cell, Diffuse - therapy
Male
Middle Aged
Neoplasm Staging
Non-Hodgkin lymphoma
Recurrence
relapse
Retrospective Studies
Stem Cell Transplantation
Survival Analysis
Transplantation, Autologous
Treatment Outcome
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Summary:Forty patients with relapsed diffuse large B cell lymphoma (DLBCL) autografted in partial response (PR) (n = 23) or in refractory relapse (RR) (n = 17) achieved complete remission (CR) after autologous stem cell transplantation (ASCT). Salvage treatment consisted of ifosphamide, epirubicin and etoposide (IEV) in 33 patients and Cisplatinum, ARA‐C and dexamethasone (DHAP) in 7 patients. All PR and 8 RR patients were conditioned with BEAM, while 9 RR cases received the BCV regimen. There were no significant differences between the two groups as age, serum LDH, duration of CR1 and IPI at relapse are concerned. Relapse rate after ASCT was 39% in PR group as opposed to 88% in RR group (p = 0.003). Median relapse free survival from ASCT was 6 months for RR patients as opposed to 34 months for PR patients (p = 0.003); median overall survival from ASCT was 10 months for RR subset as opposed to not reached for RR subgroup (p = 0.001). These data demonstrate that CR achieved after ASCT in DLBCL patients who are refractory to previous salvage therapy does not result in long‐term disease control. Alternative preparative regimens, allogeneic SCT and/or monoclonal antibodies in the post‐ASCT phase should be considered for RR patients despite CR achievement. Copyright © 2006 John Wiley & Sons, Ltd.
ISSN:0278-0232
1099-1069
DOI:10.1002/hon.773