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Blood Res. 2014 Jun;49(2):107-14. doi: 10.5045/br.2014.49.2.107. Epub 2014 Jun 25.

R-CHOP chemoimmunotherapy followed by autologous transplantation for the treatment of diffuse large B-cell lymphoma.

Author information

  • 1Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 3Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 4Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
  • 5Department of Medicine, Samsung Medical Center, Seoul, Korea.
  • 6Department of Internal Medicine, the Catholic University of Korea, Seoul, Korea.
  • 7Department of Internal Medicine, Hanyang University, Seoul, Korea.
  • 8Department of Internal Medicine, Gachon University, Incheon, Korea.
  • 9Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea.
  • 10Department of Internal Medicine, National Cancer Center, Ilsan, Korea.
  • 11Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
  • 12Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
  • 13Department of Internal Medicine, Yonsei University, Seoul, Korea.
  • 14Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.

Abstract

BACKGROUND:

We investigated factors that influence outcomes in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab combined with the CHOP regimen (R-CHOP) followed by upfront autologous stem cell transplantation (Auto-SCT).

METHODS:

We retrospectively evaluated survival differences between subgroups based on the age-adjusted International Prognostic Index (aaIPI) and revised-IPI (R-IPI) at diagnosis, disease status, and positron emission tomographic/computerized tomographic (PET/CT) status at transplantation in 51 CD20-positive DLBCL patients treated with R-CHOP followed by upfront Auto-SCT.

RESULTS:

Patients had either stage I/II bulky disease (5.9%) or stage III/IV disease (94.1%). The median patient age at diagnosis was 47 years (range, 22-66 years); 53.3% and 26.7% had high-intermediate and high risks according to aaIPI, respectively. At the time of Auto-SCT, 72.5% and 27.5% experienced complete (CR) and partial remission (PR) after R-CHOP, respectively. The median time from diagnosis to Auto-SCT was 7.27 months (range, 3.4-13.4 months). The 5-year overall (OS) and progression-free survival (PFS) were 77.3% and 72.4%, respectively. The 5-year OS and PFS rates according to aaIPI, R-IPI, and PET/CT status did not differ between the subgroups. More importantly, the 5-year OS and PFS rates of the patients who achieved PR at the time of Auto-SCT were not inferior to those of the patients who achieved CR (P=0.223 and 0.292, respectively).

CONCLUSION:

Survival was not influenced by the aaIPI and R-IPI at diagnosis, disease status, or PET/CT status at transplantation, suggesting that upfront Auto-SCT might overcome unfavorable outcomes attributed to PR after induction chemoimmunotherapy.

KEYWORDS:

Autologous transplantation; Diffuse large B-cell lymphoma; Hematopoietic stem cell transplantation; Rituximab; Survival analysis

PMID:
25025012
PMCID:
PMC4090331
DOI:
10.5045/br.2014.49.2.107
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