Improved relapse-free survival after autologous stem cell transplantation does not translate into better quality of life in chronic lymphocytic leukemia: Lessons from the randomized European Society for Blood and Marrow Transplantation-Intergroup study

Autor: Michal Karas, Bernadette Corront, Jehan Dupuis, Mauricette Michallet, Claire Dearden, Donald Milligan, Maggie Watson, Sylvain Choquet, Nicolaus Kröger, Gabriela M. Baerlocher, Liesbeth C. de Wreede, J. Homewood, Peter Dreger, Michel van Gelder, Wolfgang Herr, Laurent Sutton, Dietger Niederwieser, Johannes Schetelig, Michel Leporrier, Marleen van Os, Theo de Witte
Přispěvatelé: Dept. of Medical Statistics, Universiteit Leiden [Leiden], European Society for Blood and Marrow Transplantation (EBMT), Laboratoire de Développements Méthodologiques en Tomographie par Emission de Positons (LDM-TEP), Service Hospitalier Frédéric Joliot (SHFJ), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Imagerie et Stratégies Thérapeutiques des pathologies Cérébrales et Tumorales (ISTCT), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS), Universiteit Leiden, Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Imagerie et Stratégies Thérapeutiques des pathologies Cérébrales et Tumorales (ISTCT), Interne Geneeskunde, RS: GROW - Oncology, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Transplantation Conditioning
Randomization
Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2]
[SDV]Life Sciences [q-bio]
medicine.medical_treatment
Chronic lymphocytic leukemia
Hematopoietic stem cell transplantation
Transplantation
Autologous
03 medical and health sciences
0302 clinical medicine
Autologous stem-cell transplantation
Quality of life
Recurrence
Surveys and Questionnaires
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Clinical endpoint
Humans
ComputingMilieux_MISCELLANEOUS
Aged
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
medicine.disease
Leukemia
Lymphocytic
Chronic
B-Cell
humanities
3. Good health
Surgery
Transplantation
030220 oncology & carcinogenesis
Quality of Life
Female
business
030215 immunology
Zdroj: American Journal of Hematology
American Journal of Hematology, Wiley, 2014, 89 (2), pp.174-180. ⟨10.1002/ajh.23610⟩
American Journal of Hematology, 2014, 89 (2), pp.174-180. ⟨10.1002/ajh.23610⟩
American Journal of Hematology, 89, 2, pp. 174-80
American Journal of Hematology, 89, 174-80
American Journal of Hematology, 89(2), 174-180. Wiley
ISSN: 1096-8652
0361-8609
DOI: 10.1002/ajh.23610⟩
Popis: Item does not contain fulltext In chronic lymphocytic leukemia (CLL) medical progress is driven by clinical studies with relapse-free survival (RFS) as the primary endpoint. The randomized EBMT-Intergroup trial compared high-dose therapy and autologous stem cell transplantation (ASCT) to observation and demonstrated a substantial improvement of RFS without showing improved overall survival for the transplant arm. Here we report quality of life (QoL) information of the first 3 years following randomization from that study. The main objective was to assess the impact of treatment on QoL over time. Two secondary analyses were performed to further investigate the impact of ASCT and relapse on QoL. In the primary analysis, we demonstrate an adverse impact of ASCT on QoL which was largest at 4 months and continued throughout the first year after randomization. Further, we demonstrated a sustained adverse impact of relapse on QoL which worsened over time. Despite better disease control by ASCT the side effects thus turned the net effect towards inferior QoL in the first year and comparable QoL in the following 2 years after randomization. This study emphasizes the importance of information concerning QoL impacts when patients are counseled about treatments aimed at improving RFS in the absence of a survival benefit.
Databáze: OpenAIRE
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