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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

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

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