Role of frontline autologous stem cell transplantation in young, high-risk diffuse large B-cell lymphoma patients
The Korean Journal of Internal Medicine
; : 362-371, 2015.
Article
em En
| WPRIM
| ID: wpr-62998
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WPRO
ABSTRACT
BACKGROUND/AIMS: Several studies have demonstrated the effect of autologous hematopoietic stem cell transplantation (auto-HSCT) as a salvage treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL). However, the role of auto-HSCT as a frontline treatment has not been fully investigated in the rituximab era. We validated the age-adjusted International Prognostic Index (aaIPI) score for high-risk DLBCL patients and identified a possible role for frontline auto-HSCT. METHODS: We recommended frontline auto-HSCT for high-risk DLBCL patients who satisfied the criteria of both a higher Ann-Arbor stage (III to IV) and an elevated lactate dehydrogenase (LDH) level at diagnosis with an aaIPI score > or = 2. From 2006 to 2011, among the 150 DLBCL patients aged or = 2 showed inferior overall survival (OS; p = 0.040) and progression-free survival (PFS; p = 0.007) compared to the aaIPI score 0 to 1. Between the two treatment arms among the high-risk DLBCL patients, the clinical parameters were not different. The high-risk group treated with frontline auto-HSCT showed similar OS (p = 0.392) and PFS (p = 0.670) to those in the low-risk group. Thus, frontline auto-HSCT showed superior PFS (p = 0.004), but only a trend towards favorable OS (p = 0.091) compared to R-CHOP alone. CONCLUSIONS: We identified the possible role of frontline auto-HSCT for high-risk DLBCL with a higher stage (III to IV) and elevated LDH level.
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Assunto principal:
Fatores de Tempo
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Transplante Autólogo
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Vincristina
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Prednisona
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Protocolos de Quimioterapia Combinada Antineoplásica
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Doxorrubicina
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Biomarcadores Tumorais
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Modelos de Riscos Proporcionais
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Regulação para Cima
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Valor Preditivo dos Testes
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
/
Male
Idioma:
En
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2015
Tipo de documento:
Article