Time-dependent effect of non-Hodgkin's lymphoma grade on disease-free survival of relapsed/refractory patients treated with high-dose chemotherapy plus autotransplantation
| Autor: | Omer N. Koc, Hillard M. Lazarus, Pingfu Fu, S. L. Gerson, D.J. Bajor, Z. Xu, Mary J. Laughlin, Richard J. Creger, W.J. van Heeckeren, Pathik D. Wadhwa, Brenda W. Cooper |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty medicine.medical_treatment Transplantation Autologous Disease-Free Survival Time Autologous stem-cell transplantation hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Pharmacology (medical) Etoposide Survival analysis Aged Proportional Hazards Models Models Statistical Proportional hazards model business.industry Lymphoma Non-Hodgkin General Medicine Middle Aged medicine.disease Carmustine Autotransplantation Lymphoma Non-Hodgkin's lymphoma Surgery Transplantation Treatment Outcome Female Cisplatin business Stem Cell Transplantation medicine.drug |
| Zdroj: | Contemporary Clinical Trials. 29:157-164 |
| ISSN: | 1551-7144 |
| DOI: | 10.1016/j.cct.2007.07.005 |
| Popis: | Evaluation of time to event outcomes usually is examined by the Kaplan-Meier method and Cox proportional hazards models. We developed a modified statistical model based on histologic grade and other variables to describe the time-dependent outcome for autologous stem cell transplant (autotransplant) performed for non-Hodgkin's lymphoma (NHL) based on histologic grade and other variables. One hundred and fourteen relapsed or refractory NHL patients were treated using BCNU 600 mg/m2, etoposide 2400 mg/m2, and cisplatin 200 mg/m2 IV followed by autotransplant. Median age was 53.5 (range: 25-70) years, 78 patients had aggressive NHL and 36 indolent NHL. Seventy-five patients received involved-field radiotherapy just prior to transplant. At a median follow-up of 33 (range: 3 to 118) months, the estimated 5-year Kaplan-Meier probabilities of overall survival and disease-free survival were 61% and 51%, respectively. Cox proportional hazards model analysis showed that proportionality did not hold for lymphoma grade, indicating that the relationship between the grade and disease-free survival differed over time. By piece-wise Cox model, the relative risk for experiencing relapse or death after 1 year in patients with indolent compared with patients with aggressive NHL was 2.81 (p=0.019) with 95% confidence interval (1.19, 6.65). The time-dependent effect of lymphoma grade on disease-free survival suggests the need for early (within first year) incorporation of novel therapeutic approaches in management of patients with indolent NHL undergoing autotransplant. |
| Databáze: | OpenAIRE |
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