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Late Relapses After High-dose Chemotherapy and Autologous Stem Cell Transplantation in Patients With Diffuse Large B-cell Lymphoma in the Rituximab Era
- Source :
- Clinical Lymphoma Myeloma and Leukemia. 17:145-151
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background The standard of care for diffuse large B-cell lymphoma (DLBCL) relapsing after front-line therapy is high-dose chemotherapy and autologous stem cell transplantation (ASCT). Evidence has suggested that early relapses (ie, within 1 year) after this approach portends exceptionally poor outcomes. However, data examining relapses > 1 year after ASCT for patients with refractory or relapsed DLBCL are limited, in particular, in the rituximab era. We sought to examine the effect of early (≤ 1 year) and late (> 1 year) relapse after ASCT in a single-institution cohort of patients with relapsed and refractory DLBCL treated with chemoimmunotherapy. Materials and Methods A retrospective analysis was performed on the data from 85 consecutive patients who had undergone ASCT for biopsy-confirmed relapsed or refractory DLBCL from 2001 to 2010 at the University of Rochester Medical Center. All patients had received rituximab as a part of treatment. Of the 85 patients, 35 developed relapse after ASCT. These 35 patients were divided into 2 groups according to the timing of the relapse (≤ 1 year and > 1 year after ASCT). Results The median follow-up period was 6.4 years. For all patients, the overall survival (OS) from post-ASCT relapse was 5.2 years. For the 27 patients developing relapse at ≤ 1 year after ASCT, the median OS was 0.6 year and progression-free survival was 0.4 year. For the 8 patients developing relapse at > 1 year after ASCT, the median OS was 5.9 years and progression-free survival was 2.9 years. Conclusion Patients with relapsed or refractory DLBCL experiencing relapse > 1 year after ASCT had good outcomes. Despite the relative rarity in incidence, a significant risk of relapse of DLBCL after ASCT remains, suggesting the need for continued monitoring because of the possibility of later progression.
- Subjects :
- Adult
Male
Oncology
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Antineoplastic Agents
Transplantation, Autologous
Disease-Free Survival
Young Adult
03 medical and health sciences
0302 clinical medicine
Autologous stem-cell transplantation
Refractory
Chemoimmunotherapy
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Chemotherapy
business.industry
Incidence (epidemiology)
Hematology
Middle Aged
medicine.disease
Combined Modality Therapy
Lymphoma
Surgery
030220 oncology & carcinogenesis
Disease Progression
Female
Rituximab
Lymphoma, Large B-Cell, Diffuse
Neoplasm Recurrence, Local
business
Diffuse large B-cell lymphoma
Follow-Up Studies
Stem Cell Transplantation
030215 immunology
medicine.drug
Subjects
Details
- ISSN :
- 21522650
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Clinical Lymphoma Myeloma and Leukemia
- Accession number :
- edsair.doi.dedup.....89977fbd0d58f8e5b3dd81b04b41b593