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The role of additional chemotherapy prior to autologous HCT in patients with relapse/refractory DLBCL in partial remission-A retrospective multicenter study.
Shargian, Liat; Amit, Odelia; Bernstine, Hanna; Gurion, Ronit; Gafter-Gvili, Anat; Rozovski, Uri; Pasvolsky, Oren; Perets, Galit; Horowitz, Netanel A; Halloun, Jabour; Perry, Chava; Avivi, Irit; Raanani, Pia; Yeshurun, Moshe; Ram, Ron.
Afiliación
  • Shargian L; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.
  • Amit O; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Bernstine H; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Gurion R; Institute of Hematology, Sourasky Medical Center, Tel-Aviv, Israel.
  • Gafter-Gvili A; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Rozovski U; Department of Nuclear Medicine, Rabin Medical Center, Petah-Tikva, Israel.
  • Pasvolsky O; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.
  • Perets G; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Horowitz NA; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.
  • Halloun J; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Perry C; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.
  • Avivi I; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Raanani P; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.
  • Yeshurun M; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Ram R; Department of Hematology and Bone Marrow Transplantation, Soroka Medical center and Faculty of Medicine, Beer Sheva, Israel.
Eur J Haematol ; 110(2): 149-156, 2023 Feb.
Article en En | MEDLINE | ID: mdl-36251268
ABSTRACT

OBJECTIVES:

To evaluate the role of additional chemotherapy before autologous hematopoietic cell transplantation (HCT) in patients with relapse/refractory diffuse large B-cell lymphoma (DLBCL) who achieve partial remission following first salvage therapy.

METHODS:

We conducted a multicenter retrospective study of all adult patients with DLBCL who underwent HCT between 2008 and 2020 and achieved partial response (PR) after the first salvage and were either referred directly to HCT (n = 47) or received additional salvage therapy before HCT (n = 22).

RESULTS:

Post-HCT CR rate and progression-free survival were comparable between the two groups (66% vs. 68%, p = .86 and median not reached vs. 10.2 months [95% confidence interval, CI 7.1-12.3], p = .27, respectively). Median overall survival (OS) and estimated 3-year OS favored patients who were directly referred to HCT (105.8 [95% CI 63-148] months vs. 14.5 [95% CI 0-44] months, p = .035, and 65% [95% CI 51%-75%] vs. 40% [95% CI 21%-53%], p = .035, respectively). In Cox regression model, while International Prognostic Index and primary refractory versus relapse disease did not impact OS, allocation to a second salvage regimen and older age were both associated with inferior survival (hazard ratio [HR] = 2.57 95% CI 1.1-5.8, p = .023 and HR = 1.04 95% CI 0.99-1.2, p = .064, respectively).

CONCLUSIONS:

Referring patients with chemotherapy-sensitive disease in PR directly to HCT is associated with better OS compared to those receiving additional lines of treatment.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Linfoma no Hodgkin / Linfoma de Células B Grandes Difuso / Trasplante de Células Madre Hematopoyéticas / Recurrencia Local de Neoplasia Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Israel

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Linfoma no Hodgkin / Linfoma de Células B Grandes Difuso / Trasplante de Células Madre Hematopoyéticas / Recurrencia Local de Neoplasia Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Israel