BACKGROUND: The purpose of this study was to analyse the results and prognostic factors influencing overall survival (OS) and disease-free survival (DFS) in 452 patients diagnosed with diffuse large cell lymphomas (DLCL) treated with high-dose therapy (HDT) included in the Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL-TAMO) Spanish registry. PATIENTS AND METHODS: At transplantation, median age was 42 years (range 15-73), 146 patients (32%) were transplanted in first complete remission (1st CR), 19% in second CR (2nd CR) and 47% had active disease: sensitive disease in 157 (35%) patients [95 were in first partial remission (1st PR) and 62 in second PR (2nd PR)] and refractory disease in 55 (12%) patients. Age-adjusted International Prognostic Index (IPI) was 2 or 3 in 51 patients (12%). Conditioning regimen consisted of BEAM (carmustine, etoposide, cytarabine and melphalan) in 39% of patients, BEAC (carmustine, etoposide, cytarabine and cyclophosphamide) in 33%, CBV (carmustine, etoposide and cyclophosphamide) in 10% and cyclophosphamide plus total body irradiation (TBI) in 12%. RESULTS: Estimated overall survival (OS) and disease-free survival (DFS) at 5 years were 53% and 43%, respectively. The transplant-related mortality was 11% (53 cases). By multivariate analysis three variables significantly influenced OS and DFS: number of protocols to reach 1st CR, disease status at transplant and TBI in the conditioning regimen. Age-adjusted IPI at transplantation also influenced OS. CONCLUSIONS: Prolonged OS and DFS can be achieved in patients with DLCL after HDT and our results suggest that the best line of chemotherapy should be used up-front in patients considered as candidates for HDT in order to obtain an early CR. Resistant patients are not good candidates for HDT and they should be offered newer strategies. Finally, polichemotherapy conditioning regimens offer better results compared with TBI.
BACKGROUND: The purpose of this study was to analyse the results and prognostic factors influencing overall survival (OS) and disease-free survival (DFS) in 452 patients diagnosed with diffuse large cell lymphomas (DLCL) treated with high-dose therapy (HDT) included in the Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GEL-TAMO) Spanish registry. PATIENTS AND METHODS: At transplantation, median age was 42 years (range 15-73), 146 patients (32%) were transplanted in first complete remission (1st CR), 19% in second CR (2nd CR) and 47% had active disease: sensitive disease in 157 (35%) patients [95 were in first partial remission (1st PR) and 62 in second PR (2nd PR)] and refractory disease in 55 (12%) patients. Age-adjusted International Prognostic Index (IPI) was 2 or 3 in 51 patients (12%). Conditioning regimen consisted of BEAM (carmustine, etoposide, cytarabine and melphalan) in 39% of patients, BEAC (carmustine, etoposide, cytarabine and cyclophosphamide) in 33%, CBV (carmustine, etoposide and cyclophosphamide) in 10% and cyclophosphamide plus total body irradiation (TBI) in 12%. RESULTS: Estimated overall survival (OS) and disease-free survival (DFS) at 5 years were 53% and 43%, respectively. The transplant-related mortality was 11% (53 cases). By multivariate analysis three variables significantly influenced OS and DFS: number of protocols to reach 1st CR, disease status at transplant and TBI in the conditioning regimen. Age-adjusted IPI at transplantation also influenced OS. CONCLUSIONS: Prolonged OS and DFS can be achieved in patients with DLCL after HDT and our results suggest that the best line of chemotherapy should be used up-front in patients considered as candidates for HDT in order to obtain an early CR. Resistant patients are not good candidates for HDT and they should be offered newer strategies. Finally, polichemotherapy conditioning regimens offer better results compared with TBI.
Authors: Yago Nieto; Peter Thall; Ben Valdez; Borje Andersson; Uday Popat; Paolo Anderlini; Elizabeth J Shpall; Roland Bassett; Amin Alousi; Chitra Hosing; Partow Kebriaei; Muzaffar Qazilbash; Erin Frazier; Alison Gulbis; Christina Chancoco; Qaiser Bashir; Stefan Ciurea; Issa Khouri; Simrit Parmar; Nina Shah; Laura Worth; Gabriela Rondon; Richard Champlin; Roy B Jones Journal: Biol Blood Marrow Transplant Date: 2012-05-27 Impact factor: 5.742
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Authors: Javier Briones; Silvana Novelli; José A García-Marco; José F Tomás; Teresa Bernal; Carlos Grande; Miguel A Canales; Antonio Torres; José M Moraleda; Carlos Panizo; Isidro Jarque; Francisca Palmero; Miguel Hernández; Eva González-Barca; Dulce López; Dolores Caballero Journal: Haematologica Date: 2013-10-25 Impact factor: 9.941
Authors: Partow Kebriaei; Timothy Madden; Reza Kazerooni; Xuemei Wang; Peter F Thall; Celina Ledesma; Yago Nieto; Elizabeth J Shpall; Chitra Hosing; Muzaffar Qazilbash; Uday Popat; Issa Khouri; Richard E Champlin; Roy B Jones; Borje S Andersson Journal: Biol Blood Marrow Transplant Date: 2010-07-30 Impact factor: 5.742
Authors: Yi-Bin Chen; Andrew A Lane; Brent Logan; Xiaochun Zhu; Görgün Akpek; Mahmoud Aljurf; Andrew Artz; Christopher N Bredeson; Kenneth R Cooke; Vincent T Ho; Hillard M Lazarus; Richard Olsson; Wael Saber; Philip McCarthy; Marcelo C Pasquini Journal: Biol Blood Marrow Transplant Date: 2015-02-14 Impact factor: 5.742
Authors: Partow Kebriaei; Helen Huls; Bipulendu Jena; Mark Munsell; Rineka Jackson; Dean A Lee; Perry B Hackett; Gabriela Rondon; Elizabeth Shpall; Richard E Champlin; Laurence J N Cooper Journal: Hum Gene Ther Date: 2012-01-17 Impact factor: 5.695
Authors: Yago Nieto; Benigno C Valdez; Peter F Thall; Sairah Ahmed; Roy B Jones; Chitra Hosing; Uday Popat; Elizabeth J Shpall; Muzaffar Qazilbash; Alison Gulbis; Paolo Anderlini; Amin Alousi; Nina Shah; Qaiser Bashir; Yan Liu; Yasuhiro Oki; Frederick Hagemeister; Michelle Fanale; Bouthaina Dabaja; Chelsea Pinnix; Richard Champlin; Borje S Andersson Journal: Biol Blood Marrow Transplant Date: 2015-06-11 Impact factor: 5.742
Authors: Julie M Vose; Shelly Carter; Linda J Burns; Ernesto Ayala; Oliver W Press; Craig H Moskowitz; Edward A Stadtmauer; Shin Mineshi; Richard Ambinder; Timothy Fenske; Mary Horowitz; Richard Fisher; Marcie Tomblyn Journal: J Clin Oncol Date: 2013-03-11 Impact factor: 44.544
Authors: Yago Nieto; Benigno C Valdez; Peter F Thall; Roy B Jones; Wei Wei; Alan Myers; Chitra Hosing; Sairah Ahmed; Uday Popat; Elizabeth J Shpall; Muzaffar Qazilbash; Alison Gulbis; Paolo Anderlini; Nina Shah; Qaiser Bashir; Amin Alousi; Yasuhiro Oki; Michelle Fanale; Bouthaina Dabaja; Chelsea Pinnix; Richard Champlin; Borje S Andersson Journal: Cancer Date: 2016-05-20 Impact factor: 6.860