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Survival impact of rituximab combined with ACVBP and upfront consolidation autotransplantation in high-risk diffuse large B-cell lymphoma for GELA
- Source :
- Haematologica. 96:1136-1143
- Publication Year :
- 2011
- Publisher :
- Ferrata Storti Foundation (Haematologica), 2011.
-
Abstract
- As rituximab combined with CHOP improves complete remission and overall survival in diffuse large B-cell lymphoma, intensified chemotherapy followed by autologous stem-cell transplantation has also been advocated for high-risk patients. The aim of this study was to establish whether or not combining rituximab with high-dose chemotherapy and auto-transplantation also benefits patient survival.The LNH2003-3 study was a phase II trial including diffuse large B-cell lymphoma patients with 2 or 3 International Prognostic Index factors. They received four cycles of intensive biweekly chemotherapy with rituximab, doxorubicine, cyclophosphamide, vindesine, bleomycine, prednisolone (R-ACVBP) followed by auto-transplantation in responding patients. Two hundred and nine patients under 60 years of age were included in the study and 155 responding patients underwent auto-transplantation. In addition, a case-control study was performed by matching (1:1) 181 patients treated with R-ACVBP with ACVBP patients not given rituximab but submitted to auto-transplantation from the previous LNH1998-3 trial.With a median follow up of 45 months, 4-year progression-free survival and overall survival were estimated at 76% (CI: 69-81) and 78% (CI: 72-83), respectively. There was no difference between patients with 2 or 3 International Prognostic Index factors. Four year progression-free survival was significantly higher in R-ACVBP than ACVBP patients (74% vs. 58%; P=0.0005). There was also a significant increase in 4-year overall survival (76% vs. 68%; P=0.0494).In high-risk diffuse large B-cell lymphoma patients, treatment with R-ACVBP followed by auto-transplantation results in a 78% 4-year overall survival which should be compared to other approaches.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
Adolescent
Vindesine
medicine.medical_treatment
Hematopoietic stem cell transplantation
Transplantation, Autologous
Antibodies, Monoclonal, Murine-Derived
Bleomycin
Young Adult
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Cyclophosphamide
Survival analysis
business.industry
Hematopoietic Stem Cell Transplantation
Original Articles
Hematology
Middle Aged
medicine.disease
Combined Modality Therapy
Survival Analysis
Autotransplantation
Lymphoma
Surgery
Transplantation
Treatment Outcome
Doxorubicin
Case-Control Studies
Prednisone
Female
Rituximab
Lymphoma, Large B-Cell, Diffuse
business
Diffuse large B-cell lymphoma
medicine.drug
Subjects
Details
- ISSN :
- 15928721 and 03906078
- Volume :
- 96
- Database :
- OpenAIRE
- Journal :
- Haematologica
- Accession number :
- edsair.doi.dedup.....43a68de5ae5964d8af3e04dd8f09007c