Autologous Hematopoietic Stem Cell Transplantation is an Effective Treatment Option in Early Relapsed and Primary Refractory Diffuse Large B-Cell Lymphoma.

Abstract

Introduction: 10-15% of diffuse large B-cell lymphomas (DLBCL) patients fail to achieve complete response (CR) after R-CHOP, and are considered primary refractory. There is limited transplant data in this population.
 Objetive: to evaluate the outcomes of primary refractory DLBCL patients transplanted at our center.
 Results: we evaluated 34 R/R patients treated with R-CHOP as first line. After second line, 30.4% of primary refractory/early relapse achieved CR, and 88.2% did so after ASCT. Median follow-up: 56.1 months, median OS was not reached; the estimated 5-year OS was 61.7%. Median OS of late relapse (Group 1) was not reached, and was 52 months for primary refractory/early relapse (Group 2) (p=0.023). The 5-year OS was 87.5% in Group 1 vs 49% in Group 2 (p=0.023).
 Conclusions: Primary refractory and early relapsed DLBCL undergoing second-line therapy and ASCT have worse OS compared to late relapse. However, 49% of primary refractory patients who proceeded to ASCT had prolonged survival, which supports the role of ASCT in this population.