R-CHOP chemoimmunotherapy followed by autologous transplantation for the treatment of diffuse large B-cell lymphomaopen access
- Authors
- Lee, Hong Ghi; Choi, Yunsuk; Kim, Sung-Yong; Kim, Inho; Kim, Yeo-Kyeoung; Kim, Yang Soo; Lee, Ho Sup; Kim, Seok Jin; Kim, Jeong-A; Park, Byeong-Bae; Park, Jinny; Shim, Hyeok; Eom, Hyeon Seok; Lee, Junglim; Park, Sung Kyu; Cheong, June-Won; Park, Keon Woo
- Issue Date
- Jun-2014
- Publisher
- Korean Society of Hematology
- Keywords
- Autologous transplantation; Diffuse large B-cell lymphoma; Hematopoietic stem cell transplantation; Rituximab; Survival analysis
- Citation
- Blood Research, v.49, no.2, pp.107 - 114
- Indexed
- SCOPUS
KCI
- Journal Title
- Blood Research
- Volume
- 49
- Number
- 2
- Start Page
- 107
- End Page
- 114
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/159779
- DOI
- 10.5045/br.2014.49.2.107
- ISSN
- 2287-979X
- Abstract
- Background: We investigated factors that influence outcomes in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab combined with the CHOP regimen (R-CHOP) followed by upfront autologous stem cell transplantation (Auto-SCT). Methods: We retrospectively evaluated survival differences between subgroups based on the age-adjusted International Prognostic Index (aaIPI) and revised-IPI (R-IPI) at diagnosis, disease status, and positron emission tomographic/computerized tomographic (PET/CT) status at transplantation in 51 CD20-positive DLBCL patients treated with R-CHOP followed by upfront Auto-SCT. Results: Patients had either stage I/II bulky disease (5.9%) or stage III/IV disease (94.1%). The median patient age at diagnosis was 47 years (range, 22-66 years); 53.3% and 26.7% had high-intermediate and high risks according to aaIPI, respectively. At the time of Auto-SCT, 72.5% and 27.5% experienced complete (CR) and partial remission (PR) after R-CHOP, respectively. The median time from diagnosis to Auto-SCT was 7.27 months (range, 3.4-13.4 months). The 5-year overall (OS) and progression-free survival (PFS) were 77.3% and 72.4%, respectively. The 5-year OS and PFS rates according to aaIPI, R-IPI, and PET/CT status did not differ between the subgroups. More importantly, the 5-year OS and PFS rates of the patients who achieved PR at the time of Auto-SCT were not inferior to those of the patients who achieved CR (P=0.223 and 0.292, respectively). Conclusion: Survival was not influenced by the aaIPI and R-IPI at diagnosis, disease status, or PET/CT status at transplantation, suggesting that upfront Auto-SCT might overcome unfavorable outcomes attributed to PR after induction chemoimmunotherapy.
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