LACE-conditioned autologous stem cell transplantation for relapsed or refractory diffuse large B-cell lymphoma: treatment outcome and risk factor analysis from a single centre
| Autor: | Donald Macdonald, Kikkeri N. Naresh, Alejandro Contento, Jane F. Apperley, Holger W. Auner, Sarah Ellis, Edward Kanfer, Amin Rahemtulla, Richard Szydlo, Chrissy Giles, Jiří Pavlů |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Diarrhea Male Oncology Cancer Research medicine.medical_specialty Transplantation Conditioning Adolescent Cyclophosphamide Vomiting medicine.medical_treatment Transplantation Autologous Young Adult Autologous stem-cell transplantation Lomustine Recurrence Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Refractory Diffuse Large B-Cell Lymphoma Etoposide Aged Stomatitis Chemotherapy business.industry Cytarabine Hematopoietic Stem Cell Transplantation Hematology General Medicine Middle Aged medicine.disease Combined Modality Therapy Survival Analysis Surgery Treatment Outcome Drug Resistance Neoplasm Female Lymphoma Large B-Cell Diffuse business Diffuse large B-cell lymphoma medicine.drug |
| Zdroj: | Hematological Oncology. 29:75-80 |
| ISSN: | 0278-0232 |
| DOI: | 10.1002/hon.956 |
| Popis: | High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a recognized treatment option for patients with relapsed diffuse large B-cell lymphoma. We have analysed 51 patients who underwent ASCT after LACE (lomustine (CCNU), cytarabine (Ara-C), cyclophosphamide, etoposide) conditioning for relapsed (n = 34, 67%) or primary refractory (n = 17, 33%) diffuse large B-cell lymphoma. With a median follow-up of 60 months (range 2–216) the probabilities of overall survival (OS) and progression-free survival (PFS) at 5 years were 47 and 42%, respectively. The cumulative treatment-related mortality was 10% (n = 5). Probabilities for OS and PFS at 5 years were 56 and 50% for patients with chemosensitive and 29 and 27% for patients with chemorefractory disease. In multivariate analysis abnormal pre-ASCT levels of C-reactive protein (>5 mg/L) were identified as a risk factor for worse OS, whereas abnormal pre-ASCT levels of C-reactive protein and chemoresistance predicted inferior PFS. LACE followed by ASCT is an effective treatment for approximately half of patients with chemosensitive relapsed diffuse large B-cell lymphoma, and a proportion of chemorefractory patients also benefit. Copyright © 2010 John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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