Impact of prior rituximab on outcomes of autologous stem-cell transplantation in patients with relapsed or refractory aggressive B-cell lymphoma: a multicentre retrospective Spanish group of lymphoma/autologous bone marrow transplant study

Autor: Natàlia Alonso, Isidro Jarque, Marta Polo, Eulogio Conde, Eva González-Barca, Juan M. Sancho, Alba Redondo, Helena Pomares, Alejandro Martín, Maria José Requena, María José Ramírez, Maria Jose Sayas, Maria Vidal, Dolores Caballero, María Jesús Pascual, José D. González, Reyes Arranz, Pascual Fernández, Belén Quereda, Antonio Salar, Javier Lopez
Rok vydání: 2013
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Adolescent
diffuse large B-cell lymphoma
Salvage therapy
Kaplan-Meier Estimate
autologous stem-cell transplantation
Antibodies
Monoclonal
Murine-Derived
Young Adult
rituximab
International Prognostic Index
Autologous stem-cell transplantation
Recurrence
immune system diseases
hemic and lymphatic diseases
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Grade 3b Follicular Lymphoma
medicine
Humans
salvage therapy
B-cell lymphoma
Aged
Bone Marrow Transplantation
Retrospective Studies
Salvage Therapy
aggressive B-cell lymphoma
business.industry
Graft Survival
Remission Induction
Hematology
Middle Aged
Prognosis
medicine.disease
Combined Modality Therapy
Surgery
Transplantation
Treatment Outcome
Female
Rituximab
Lymphoma
Large B-Cell
Diffuse
business
Diffuse large B-cell lymphoma
medicine.drug
Zdroj: BRITISH JOURNAL OF HAEMATOLOGY
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
ISSN: 0007-1048
DOI: 10.1111/bjh.12676
Popis: Summary The use of highly effective rituximab-containing therapy for treating diffuse large B-cell lymphoma (DLBCL) makes it more difficult to salvage relapsed or refractory patients. Autologous stem-cell transplantation (ASCT) is the reference treatment for these patients, but the impact of previous exposure to rituximab on the subsequent results of ASCT remains unknown. We analysed 248 patients with relapsed or refractory DLBCL or grade 3B follicular lymphoma pre-treated with rituximab as part of first-line therapy (R+ group) who received ASCT, in comparison with a control group of 127 patients without previous exposure to rituximab (R− group). The complete remission (CR) rates were similar in both groups. Multivariate analysis identified age-adjusted International Prognostic Index at diagnosis, extranodal involvement and disease status at transplant, and the number of previous chemotherapy lines as independent factors with a negative influence on CR rate. Compared with R− patients, those in the R+ group had a significantly better progression-free survival (63% vs. 48% at 5 years) and overall survival (72% vs. 61% at 5 years). This observation was independent of other prognostic factors that affected these outcomes. In conclusion, ASCT is no less effective in patients with relapsed or refractory aggressive B-cell lymphoma pre-treated with first-line rituximab-containing therapy than in rituximab-naive patients.
Databáze: OpenAIRE
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