High-Dose Therapy and Autologous Stem-Cell Support for Chemosensitive Transformed Low-Grade Follicular Non-Hodgkin’s Lymphoma: A Case-Matched Study From the European Bone Marrow Transplant Registry
| Autor: | Catherine D. Williams, C. N. Harrison, A. K. Blystad, G. Taghipour, Andrew J. Norton, A. H. Goldstone, B. Coiffier, N. Schmitz, T. A. Lister |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Bone marrow transplant medicine.medical_treatment Disease-Free Survival hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols Follicular phase medicine Humans Lymphoma Follicular Bone Marrow Transplantation Chemotherapy Dose-Response Relationship Drug business.industry Lymphoma Non-Hodgkin Mortality rate Hematopoietic Stem Cell Transplantation Middle Aged medicine.disease Combined Modality Therapy Lymphoma Surgery Survival Rate Cell Transformation Neoplastic High dose therapy medicine.anatomical_structure Case-Control Studies Disease Progression Female Bone marrow Stem cell business Follow-Up Studies |
| Zdroj: | Journal of Clinical Oncology. 19:727-735 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2001.19.3.727 |
| Popis: | PURPOSE: To assess the outcome of high-dose therapy with autologous stem-cell support in patients with histologic transformation of low-grade follicular non-Hodgkin’s lymphoma (NHL) and identify significant prognostic factors, as well as to compare survival of these patients with that of patients with matched low-grade and de novo high- or intermediate-grade NHL undergoing the same procedure. PATIENTS AND METHODS: Fifty patients with transformed low-grade NHL have been reported to the European Bone Marrow Transplant registry. Outcome from high-dose therapy and significant prognostic factors were analyzed. Their survival was also compared with that of 200 patients with matched low-grade NHL and 200 patients with matched de novo high- or intermediate-grade NHL by a case-matched analysis. RESULTS: The procedure-related death rate among the 50 transformed NHL patients was 18%. Overall survival (OS) and progression-free survival (PFS) rates were 51% and 30% at 5 years, respectively. Median PFS time was 13 months. Raised lactate dehydrogenase levels at transformation (P = .0031) was identified as the only adverse significant predictor of PFS on multivariate analysis. A subgroup of patients with residual chemosensitive disease who attained complete remission after high-dose therapy had the best outcome, with an OS at 5 years of 69%. A comparison with matched patients with low-grade disease and with de novo high- or intermediate-grade lymphoma showed no significant difference in OS (P = .939 and P = .438, respectively). CONCLUSION: Patients with chemosensitive transformed lymphoma should be seriously considered for high-dose therapy and autologous stem-cell support. |
| Databáze: | OpenAIRE |
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