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Oncol Lett. 2017 Sep;14(3):3803-3808. doi: 10.3892/ol.2017.6589. Epub 2017 Jul 15.

Upfront high-dose chemotherapy combined with autologous stem cell transplantation: Potential survival benefit for patients with high-risk diffuse large B-cell lymphoma.

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First Department of Internal Medicine, Kansai Medical University, Hirakata, Osaka 573-1010, Japan.


In patients with diffuse large B-cell lymphoma (DLBCL) classified as high-intermediate risk or high risk using the International Prognosis Index, the efficacy of high-dose chemotherapy combined with upfront autologous stem cell transplantation (HDT/ASCT) remains controversial in the rituximab era. In the present study, 27 patients who had been treated with HDT/ASCT in an upfront setting were retrospectively analyzed, and compared with 77 patients with similar characteristics who had received conventional chemotherapy without HDT/ASCT (the non-upfront setting). The 3-year overall survival and progression-free survival rates in the upfront setting were 88.5% (P=0.0134 vs. non-upfront setting) and 68.4% (P=0.113 vs. non-upfront setting), respectively; in the non-upfront setting, the 3-year overall survival and progression-free survival rates were 60.8 and 50.6%, respectively. In conclusion, the results indicate that upfront HDT/ASCT in patients with high-risk DLBCL is feasible and may improve the outcome of these patients. It may be beneficial for patients to undergo HDT/ASCT as an early treatment, prior to the development of therapy resistance.


autologous stem cell transplantation; diffuse large B-cell lymphoma; high-dose chemotherapy; rituximab; upfront

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