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Role of frontline autologous stem cell transplantation in young, high-risk diffuse large B-cell lymphoma patients
The Korean Journal of Internal Medicine ; : 362-371, 2015.
Article in English | WPRIM | ID: wpr-62998
ABSTRACT
BACKGROUND/

AIMS:

Several studies have demonstrated the effect of autologous hematopoietic stem cell transplantation (auto-HSCT) as a salvage treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL). However, the role of auto-HSCT as a frontline treatment has not been fully investigated in the rituximab era. We validated the age-adjusted International Prognostic Index (aaIPI) score for high-risk DLBCL patients and identified a possible role for frontline auto-HSCT.

METHODS:

We recommended frontline auto-HSCT for high-risk DLBCL patients who satisfied the criteria of both a higher Ann-Arbor stage (III to IV) and an elevated lactate dehydrogenase (LDH) level at diagnosis with an aaIPI score > or = 2. From 2006 to 2011, among the 150 DLBCL patients aged or = 2 showed inferior overall survival (OS; p = 0.040) and progression-free survival (PFS; p = 0.007) compared to the aaIPI score 0 to 1. Between the two treatment arms among the high-risk DLBCL patients, the clinical parameters were not different. The high-risk group treated with frontline auto-HSCT showed similar OS (p = 0.392) and PFS (p = 0.670) to those in the low-risk group. Thus, frontline auto-HSCT showed superior PFS (p = 0.004), but only a trend towards favorable OS (p = 0.091) compared to R-CHOP alone.

CONCLUSIONS:

We identified the possible role of frontline auto-HSCT for high-risk DLBCL with a higher stage (III to IV) and elevated LDH level.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Time Factors / Transplantation, Autologous / Vincristine / Prednisone / Antineoplastic Combined Chemotherapy Protocols / Doxorubicin / Biomarkers, Tumor / Proportional Hazards Models / Up-Regulation / Predictive Value of Tests Type of study: Etiology study / Prognostic study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: The Korean Journal of Internal Medicine Year: 2015 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Time Factors / Transplantation, Autologous / Vincristine / Prednisone / Antineoplastic Combined Chemotherapy Protocols / Doxorubicin / Biomarkers, Tumor / Proportional Hazards Models / Up-Regulation / Predictive Value of Tests Type of study: Etiology study / Prognostic study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: The Korean Journal of Internal Medicine Year: 2015 Type: Article