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Oncotarget. 2017 Apr 21;8(42):73168-73176. doi: 10.18632/oncotarget.17324. eCollection 2017 Sep 22.

Prognostic analysis of DLBCL patients and the role of upfront ASCT in high-intermediate and high-risk patients.

Zhao Y#1, Wang H#1,2,3, Jin S#1, Zheng J1, Huang M1, Tang Y1, Jin Z1,4,2,3, Qiu H1,4,2,3, Tang X1,4,2,3, Fu C1,4,2,3, Han Y1,4,2,3, Wu DP1,4,2,3.

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Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Institute of Blood and Marrow Transplantation, Suzhou, China.
Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China.
Collaborative Innovation Center of Hematology of Soochow University, Suzhou, China.
Contributed equally


The role of autologous stem cell transplantation (ASCT) as a frontline treatment in patients with diffuse large B cell lymphoma (DLBCL) who are in their first remission has not been fully elucidated in the rituximab era. We analyzed 272 DLBCL patients who received 4-6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) or R-CHOP followed by ASCT, from January 2005 to June 2013 in our institution. Multivariate analysis showed the none germinal center B cell (non-GCB) subtype (P=0.014, P=0.012) and International Prognostic Index (IPI) (3-5) (P=0.004, P=0.016) were independent unfavorable predictors of overall survival (OS) and progression-free survival (PFS), respectively. To investigate the treatment effect of upfront ASCT, we selected 94 high-intermediate and high-risk DLBCL patients who achieved complete remission after R-CHOP, with 41 in the ASCT and 53 in the non-ASCT groups. Survival analysis revealed patients who received upfront ASCT compared with those who did not had better OS (3-year OS: 74.5% vs. 50.4%, P=0.029) or PFS (3-year PFS: 59.6% vs. 32.1%, P=0.004), suggesting up-front ASCT following R-CHOP could improve the outcome of high-intermediate and high-risk DLBCL patients.


autologous stem cell transplantation; diffuse large B-cell lymphoma; germinal center B cell; international prognostic index (IPI); non-germinal center B cell

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