Favorable Overall Survival in Refractory Diffuse Large B-Cell Lymphoma When Responded to High-Dose Etoposide Mobilization Chemotherapy Followed By Autologous Peripheral Blood Stem Cell Transplantation

Abstract

Objective: To evaluate the strategy of using high-dose etoposide mobilization followed by autologous peripheral blood stem cell transplantation (APBSCT) in patients with diffuse large B-cell lymphoma (DLBCL) refractory to Rituximab-based chemotherapy.Methods: Forty patients with refractory DLBCL were treated with high-dose etoposide for stem cell mobilization. All patients were in progressive disease (PD) prior to mobilization, and underwent high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (APBSCT).Results: Successful PBSC mobilization was achieved in all patients. Twenty-three patients (57.5%) showed clinical response to high-dose etoposide. After APBSCT, 17 patients (42.5%) achieved CR. The 2-year progression-free (PFS) and overall survival (OS) rate were higher in patients responded to high dose etoposide (64.1% and 77.7%) compared to those without response (11.8% and 11.8%; P<0.001 for both). The response to high dose etoposide mobilization therapy was an independent prognostic factor for CR achievement, PFS and OS after APBSCT.Conclusion: High-dose etoposide mobilization chemotherapy followed by APBSCT could rescue a proportion of patients with refractory diffuse large B-cell lymphoma who responded to etoposide mobilization regimen. DisclosuresNo relevant conflicts of interest to declare.