© 2004 European Society for Medical Oncology
Original Article |
Long-term follow-up after high-dose chemotherapy and autologous stem-cell transplantation for high-grade B-cell lymphoma suggests an improved outcome for high-risk patients with respect to the age-adjusted International Prognostic Index
Albert Ludwigs University Medical Center, Department of Hematology and Oncology, Freiburg, Germany
* Correspondence to: Dr J. Finke, Albert Ludwigs University Medical Center, Department of Hematology and Oncology, Hugstetter Str. 55, D-79106 Freiburg, Germany. Tel: +49-761-270-3408; Fax: +49-761-270-3658; Email: finke{at}mm11.ukl.uni-freiburg.de
Background: To evaluate the long-term benefit from high-dose chemotherapy (HDCT) with autologous stem-cell transplantation (ASCT), as part of the initial treatment for patients with chemosensitive, high-grade B non-Hodgkin's lymphoma (hg B-NHL), stratified according to the age-adjusted International Prognostic Index (aaIPI).
Patients and methods: Eligible patients were 33 consecutive hg B-NHL patients responding to first-line chemotherapy and fulfilling at least one of the following criteria: stage III or IV, bulky disease, elevated lactate dehydrogenase or failure to achieve complete remission (CR). Twenty-two of 33 patients (67%) had two or three risk factors with respect to the aaIPI. All patients received HDCT with ASCT after a minimum of 6 weeks of VACOP-B standard therapy and VIP-E for mobilization.
Results: After ASCT, 31 patients (94%) achieved CR. No treatment-related death occurred. The cumulative incidence of relapse at a medium follow-up of 10 years is 16% for 31 of 33 patients achieving CR. Twenty-five of 33 patients are in sustained CR with a disease-free survival of 76% [95% confidence interval (CI) 67% to 86%]. The overall survival at a median follow-up of 122 months (range 86–148) is 79% (95% CI 68% to 89%).
Conclusions: The results suggest that up-front HDCT with ASCT may improve long-term outcome in high-risk patients with chemotherapy-sensitive hg B-NHL when compared to historic populations treated solely with dose-intense chemotherapy. We observed that long-term survival of high-risk (two to three risk factors) patients is comparable to low-risk (zero to one risk factor) patients after HDCT and ASCT with a low incidence of late relapse.
Key words: age-adjusted international prognostic index (aaIPI), autologous stem-cell transplantation (ASCT), chemosensitive disease, high-grade B-cell non-Hodgkin's lymphoma (hg B-NHL), high-dose chemotherapy (HDCT), long-term follow-up
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. Gisselbrecht, J. Vose, A. Nademanee, A. M. Gianni, and A. Nagler Radioimmunotherapy for Stem Cell Transplantation in Non-Hodgkin's Lymphoma: In Pursuit of a Complete Response Oncologist, October 1, 2009; 14(suppl_2): 41 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. S. Hoppe, C. H. Moskowitz, D. A. Filippa, C. S. Moskowitz, T. Kewalramani, A. D. Zelenetz, and J. Yahalom Involved-Field Radiotherapy Before High-Dose Therapy and Autologous Stem-Cell Rescue in Diffuse Large-Cell Lymphoma: Long-Term Disease Control and Toxicity J. Clin. Oncol., April 10, 2008; 26(11): 1858 - 1864. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Veelken, S Vik Dannheim, J Schulte Moenting, U. Martens, J Finke, and A Schmitt-Graeff Immunophenotype as prognostic factor for diffuse large B-cell lymphoma in patients undergoing clinical risk-adapted therapy Ann. Onc., May 1, 2007; 18(5): 931 - 939. [Abstract] [Full Text] [PDF]
|
|