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Annals of Oncology 10:427-432, 1999
© 1999 European Society for Medical Oncology

research-article

Clinical outcome after autologous transplantation in non-Hodgkin's lymphoma patients with high international prognostic index (IPI)

S. Cortelazzo1,, A. Rossi1, P. Bellavita2, E. Oldani1, P. Viero1, M. Buelli1, A. Rambaldi1 and T. Barbui1

1Divisions of Hematology, Ospedali Riunili di Bergamo Italy
2Immunohemalology, Ospedali Riunili di Bergamo Italy

Correspondence to: Sergio Cortelazzo, MD. Divisione di Ematologia, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128 Bergamo, Italy. E-mail: ematologia{at}cyberg.it

Background: Dose intensification and autologous stem cell transplantation as front-line therapy in non-Hodgkin's lymphoma patients (NHL) is a matter for debate, although preliminary data suggest a role for it in patients at high risk of resistance or relapse according to the international prognostic index (IPI).

Purpose and study design: To compare retrospectively the clinical outcome of two cohorts of NHL patients with high-risk IPI treated with MACOP-B for 12 weeks (38 patients) or high-dose chemotherapy (44 patients) including eight weeks of MACOP-B, one or two intensification cycles with mitoxan-throne, dexamethasone, high-dose ara-C and finally BEAM chemotherapy with autologous hemopoietic progenitor cell transplantation.

Results: The actuarial estimate of event (progression, relapse or death)-free survival (EFS) at three years was better (58% vs. 41%, P = 0.08) for patients treated with the intensive regimen even though the overall survival did not show a statistically significant difference (63% vs. 50%, P = 0.27). Multivariate analysis showed that the high-dose chemotherapy program was the only independent variable correlating with a reduction in the event rate.

Conclusion: Early autologous stem-cell transplantation might improve the clinical outcome of high-risk patients according to IPI.

autologous hemopoietic stem-cell transplantation, diffuse large-cell lymphoma, international prognostic index


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