Abstract
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) has been applied to patients with diffuse large Bcell lymphoma (DLBCL); it is well established that ASCT shows significant survival benefits for chemosensitive relapse. However, half of relapsed patients are resistant to salvage chemotherapy, indicating that they are not suitable for ASCT. We retrospectively analyzed the clinical records of 47 patients with DLBCL classified as high or high-intermediate (higher) risk, according to the International Prognostic Index, who underwent upfront ASCT in first complete remission (CR1). Compared with 10 patients with similar characteristics who did not receive ASCT, event free survival at 5-year was significantly superior in ASCT group. Toxicity of ASCT was acceptable and therapy-related death was not observed. We therefore propose that upfront ASCT for higher risk DLBCL in CR1 might provide survival benefit, probably because the high-dose therapy removes minimally resided tumor.
Highlights
Favorable event free-survival of high-dose chemotherapy followed by autologous age-adjusted IPI) is considered the most valuable prognostic indicator of aggressive lymphoma.[2,3] Prognosis of patients classified as high or high-intermediate risk by IPI
Kyoto Prefectural University of Medicine, Japan only Abstract e High-dose chemotherapy followed by autolos gous stem cell transplantation (ASCT) has u been applied to patients with diffuse large Bl cell lymphoma (DLBCL); it is well established ia that ASCT shows significant survival benefits for chemosensitive relapse
Half of rc relapsed patients are resistant to salvage chemotherapy, indicating that they are not e suitable for ASCT
Summary
Favorable event free-survival of high-dose chemotherapy followed by autologous age-adjusted IPI) is considered the most valuable prognostic indicator of aggressive lymphoma.[2,3] Prognosis of patients classified as high or high-intermediate (higher) risk by IPI. Correspondence: Hiroto Kaneko, Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, hematopoietic stem cell transplantation for higher risk diffuse large B-cell lymphoma in first complete remission is extremely poor, mainly because of the high relapse rate. Kyoto Prefectural University of Medicine, Japan only Abstract e High-dose chemotherapy followed by autolos gous stem cell transplantation (ASCT) has u been applied to patients with diffuse large Bl cell lymphoma (DLBCL); it is well established ia that ASCT shows significant survival benefits for chemosensitive relapse. Other studies showed extremely poor prognosis of relapsed aggressive lymphoma despite various salvage therapy,[17,18] indicating that most of relapsed patients are not suitable for ASCT
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