LACE-conditioned autologous stem cell transplantation for relapsed or refractory diffuse large B-cell lymphoma: treatment outcome and risk factor analysis from a single centre
✍ Scribed by Jiří Pavlů; Holger W. Auner; Sarah Ellis; Richard M. Szydlo; Chrissy Giles; Alejandro Contento; Amin Rahemtulla; Jane F. Apperley; Kikkeri Naresh; Donald H. MacDonald; Edward J. Kanfer
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 109 KB
- Volume
- 29
- Category
- Article
- ISSN
- 0278-0232
- DOI
- 10.1002/hon.956
No coin nor oath required. For personal study only.
✦ Synopsis
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a recognized treatment option for patients with relapsed diffuse large B-cell lymphoma. We have analysed 51 patients who underwent ASCT after LACE (lomustine (CCNU), cytarabine (Ara-C), cyclophosphamide, etoposide) conditioning for relapsed (n ¼ 34, 67%) or primary refractory (n ¼ 17, 33%) diffuse large B-cell lymphoma. With a median follow-up of 60 months (range 2-216) the probabilities of overall survival (OS) and progression-free survival (PFS) at 5 years were 47 and 42%, respectively. The cumulative treatment-related mortality was 10% (n ¼ 5). Probabilities for OS and PFS at 5 years were 56 and 50% for patients with chemosensitive and 29 and 27% for patients with chemorefractory disease. In multivariate analysis abnormal pre-ASCT levels of C-reactive protein (>5 mg/L) were identified as a risk factor for worse OS, whereas abnormal pre-ASCT levels of C-reactive protein and chemoresistance predicted inferior PFS. LACE followed by ASCT is an effective treatment for approximately half of patients with chemosensitive relapsed diffuse large B-cell lymphoma, and a proportion of chemorefractory patients also benefit.