open access

Vol 51, No 3 (2020)
ORIGINAL RESEARCH ARTICLE
Published online: 2020-09-01
Submitted: 2020-03-21
Get Citation

Feasibility of up-front autologous stem cell transplantation for high risk diffuse large B-cell lymphoma – non-randomized analysis of 58 consecutive patients

Anna Armatys, Agata Wieczorkiewicz-Kabut, Dariusz Kata, Krzysztof Woźniczka, Anna Kopińska, Anna Koclęga, Adrianna Spałek, Grzegorz Helbig
DOI: 10.2478/ahp-2020-0027
·
Acta Haematol Pol 2020;51(3):151-156.

open access

Vol 51, No 3 (2020)
ORIGINAL RESEARCH ARTICLE
Published online: 2020-09-01
Submitted: 2020-03-21

Abstract

Introduction

High-dose chemotherapy supported by autologous stem cell transplantation (ASCT) continues to be a standard of care for relapsed diffuse large B-cell lymphoma (DLBCL) and may be considered as a frontline consolidation for a proportion of patients with high-risk features.

Aim

We evaluated the feasibility and safety of ASCT for high-risk DLBCL who are in first complete remission after standard treatment with chemotherapy ± rituximab.

Material and methods

A retrospective analysis of 58 patients (36 males and 22 females) receiving up-front ASCT between 1996 and 2018 for remission consolidation.

Results

Of the diagnosed, fifty patients were in clinical stage ≥ III. Forty-two (72%) of transplanted patients had age-adjusted IPI ≥ 2. The “B” symptoms were present in 34 patients. The conditioning consisted of cyclophosphamide, carmustine, etoposide (CBV) in 32 patients, carmustine, cytarabine, etoposide, melphalan (BEAM) in 18, and 8 patients received bendamustine, cytarabine, etoposide, melphalan (BeEAM). The transplant-related mortality was 0% at day +30 and +100 after ASCT. Median overall survival (OS) was 4.2 years whereas progression-free survival (PFS) reached 3.0 years. The estimated 5-year OS and PFS were found to be 66% and 64%, respectively. The presence of “B” symptoms remained significance in multivariate analysis (HR 4.17 [95% CI: 1.19–14.5]; = 0.02). No grade 3 or 4 non-hematological adverse events were observed.

Conclusions

Up-front ASCT was found to be a safe and feasible procedure with long-term remission in approximately 70% of patients.

Abstract

Introduction

High-dose chemotherapy supported by autologous stem cell transplantation (ASCT) continues to be a standard of care for relapsed diffuse large B-cell lymphoma (DLBCL) and may be considered as a frontline consolidation for a proportion of patients with high-risk features.

Aim

We evaluated the feasibility and safety of ASCT for high-risk DLBCL who are in first complete remission after standard treatment with chemotherapy ± rituximab.

Material and methods

A retrospective analysis of 58 patients (36 males and 22 females) receiving up-front ASCT between 1996 and 2018 for remission consolidation.

Results

Of the diagnosed, fifty patients were in clinical stage ≥ III. Forty-two (72%) of transplanted patients had age-adjusted IPI ≥ 2. The “B” symptoms were present in 34 patients. The conditioning consisted of cyclophosphamide, carmustine, etoposide (CBV) in 32 patients, carmustine, cytarabine, etoposide, melphalan (BEAM) in 18, and 8 patients received bendamustine, cytarabine, etoposide, melphalan (BeEAM). The transplant-related mortality was 0% at day +30 and +100 after ASCT. Median overall survival (OS) was 4.2 years whereas progression-free survival (PFS) reached 3.0 years. The estimated 5-year OS and PFS were found to be 66% and 64%, respectively. The presence of “B” symptoms remained significance in multivariate analysis (HR 4.17 [95% CI: 1.19–14.5]; = 0.02). No grade 3 or 4 non-hematological adverse events were observed.

Conclusions

Up-front ASCT was found to be a safe and feasible procedure with long-term remission in approximately 70% of patients.

Get Citation

Keywords

autologous stem cell transplantation; diffuse large B-cell lymphoma; remission; outcome

About this article
Title

Feasibility of up-front autologous stem cell transplantation for high risk diffuse large B-cell lymphoma – non-randomized analysis of 58 consecutive patients

Journal

Acta Haematologica Polonica

Issue

Vol 51, No 3 (2020)

Pages

151-156

Published online

2020-09-01

DOI

10.2478/ahp-2020-0027

Bibliographic record

Acta Haematol Pol 2020;51(3):151-156.

Keywords

autologous stem cell transplantation
diffuse large B-cell lymphoma
remission
outcome

Authors

Anna Armatys
Agata Wieczorkiewicz-Kabut
Dariusz Kata
Krzysztof Woźniczka
Anna Kopińska
Anna Koclęga
Adrianna Spałek
Grzegorz Helbig

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl