Time to relapse has prognostic value in patients with aggressive lymphoma enrolled onto the parma trial
| Autor: | Dominique Bron, Maurizio Martelli, Cesare Guglielmi, H. Van der Lelie, Christian Gisselbrecht, Françoise Gomez, Pieter Sonneveld, Catherine Sebban, Thierry Philip, R. Somers, Jean-Yves Cahn, Noel-Jean Milpied, Franck Chauvin, Anton Hagenbeek |
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| Přispěvatelé: | Hematology |
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Time Factors REGIMEN Salvage therapy Aggressive lymphoma Gastroenterology THERAPY law.invention CISPLATIN NON-HODGKINS-LYMPHOMA BONE-MARROW TRANSPLANTATION HIGH-DOSE CHEMOTHERAPY STEM-CELL TRANSPLANTATION MALIGNANT-LYMPHOMA THERAPY DEXAMETHASONE CISPLATIN SURVIVAL REGIMEN HIGH-DOSE CHEMOTHERAPY Randomized controlled trial law Recurrence Internal medicine MALIGNANT-LYMPHOMA Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies NON-HODGKINS-LYMPHOMA Prospective cohort study Bone Marrow Transplantation Proportional Hazards Models Univariate analysis business.industry Proportional hazards model Lymphoma Non-Hodgkin Cytarabine STEM-CELL TRANSPLANTATION BONE-MARROW TRANSPLANTATION Middle Aged medicine.disease Prognosis Combined Modality Therapy Surgery Lymphoma DEXAMETHASONE Oncology SURVIVAL Female business medicine.drug |
| Zdroj: | Journal of Clinical Oncology, 16(10), 3264-3269. American Society of Clinical Oncology |
| ISSN: | 0732-183X |
| Popis: | PURPOSE The purpose of this study was to investigate the prognostic value of time to relapse in 188 adult patients with intermediate- or high-grade non-Hodgkin's lymphoma (NHL) included on the Parma trial at the time of their first relapse. PATIENTS AND METHODS The median follow-up of these patients is 102 months after registration onto the Parma study. Time to relapse was calculated from initial diagnosis, and a cutoff of 12 months was used to separate 77 patients defined as early relapse from 111 patients defined as late relapse. RESULTS Patients with early and late relapses had significantly different overall response rates to salvage therapy with two courses of dexamethasone, high-dose cytarabine, and cisplatin (DHAP; 40% v 69%; P=.00007) and different 8-year survival rates (13% v 29%; P=.00001). Features at relapse with a negative prognostic value in univariate analysis were higher than normal lactic dehydrogenase (LDH) levels, tumor size greater than 5 cm, Ann Arbor stages III to IV, and Karnofsky score less than 80%. Therefore, multivariate analyses were performed. Time to relapse (P=.001) and LDH levels at relapse (P=.003) had independent prognostic value, whereas tumor size did not reach statistical significance in the logistic model that predicted overall response after two courses of DHAP. The study of prognostic factors for overall survival (OS) and progression-free survival (PFS) confirmed the prognostic value of time to relapse (P < .0001 for OS and P=.005 for PFS) independent of response or treatment after two courses of DHAP. CONCLUSION Time to relapse may be used to stratify patients at time of first relapse of intermediate to high-grade non-Hodgkin's lymphoma. |
| Databáze: | OpenAIRE |
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