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Annals of Oncology 2004 15(12):1790-1797; doi:10.1093/annonc/mdh471
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© 2004 European Society for Medical Oncology

Original Article

All aggressive lymphoma subtypes do not share similar outcome after front-line autotransplantation: a matched-control analysis by the Groupe d'Etude des Lymphomes de l'Adulte (GELA)

N. Mounier*, C. Gisselbrecht, J. Brière, C. Haioun, P. Feugier, F. Offner, C. Recher, A. Stamatoullas, F. Morschhauser, M. Macro, C. Thieblemont, A. Sonet, B. Fabiani and F. Reyes On behalf of the Groupe d'Etude des Lymphomes de l'Adulte (GELA)

Hôpital Saint Louis, AP-HP, Paris, France

* Correspondence to: Dr N. Mounier, Groupe d'Etude des Lymphomes de l'Adulte (GELA), INSERM ERM0220, Hôpital Saint Louis, AP-HP, 1 avenue Claude Vellefaux, 75010 Paris, France. Tel: +33-1-42-49-92-96; Fax: +33-1-42-49-96-41; Email: nicolas.mounier{at}sls.ap-hop-paris.fr

Background: Data are still conflicting on the indication of front-line autologous stem-cell transplantation (ASCT) as consolidation for aggressive lymphoma. To assess the therapeutic effect of ASCT among different aggressive lymphoma subtypes, we conducted a matched-control analysis by pooling the data from two Groupe d'Etude des Lymphomes de l'Adulte (GELA) trials.

Patients and methods: Between October 1987 and September 1998, 330 patients received ASCT after achieving complete remission with the ACBVP induction regimen. The histological slides showed: B aggressive non-Hodgkin's lymphoma (B-NHL) in 249 patients (75%), T-NHL in 52 patients (15%) (including 23 T anaplastic) and non-classified NHL in 29 patients. The age-adjusted International Prognostic Index (aaIPI) was 2 or 3 in 66%. Patients were matched with controls from the same GELA database but treated with chemotherapy only.

Results: ASCT did not benefit non-anaplastic T-NHL patients [5-year overall survival (OS) 44% (chemotherapy) versus 49% (ASCT), P=0.87; disease-free survival (DFS) 38% versus 45%, P=0.89] in comparison with B-NHL [5-year OS 77% (chemotherapy) versus 79% (ASCT), P=0.64; DFS 67% versus 72%, P=0.13]. However, for B-NHL patients with aaIPI score 2 or 3, the benefit of ASCT was significant.

Conclusions: This cohort study confirms the high efficacy of front-line ASCT in responding aggressive B-NHL patients with adverse prognostic factors.

Key words: aggressive lymphoma, autotransplantation, B phenotype, prognostic factors, survival analysis, T phenotype


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