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High‐dose therapy and autologous stem‐cell transplantation can improve event‐free survival for indolent lymphoma
Author(s) -
Vignot Steéphane,
Mounier Nicolas,
Larghero Jeérôme,
Brice Pauline,
Quero Laurent,
de Bazelaire Ceédric,
Ertault Marjan,
Brière Josette,
Madelaine Isabelle,
Gisselbrecht Christian
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22383
Subject(s) - medicine , autologous stem cell transplantation , follicular lymphoma , oncology , lymphoma , transplantation , surgery
BACKGROUND. High‐dose therapy (HDT) and autologous stem‐cell transplantation (ASCT) remain controversial for indolent lymphoma patients. METHODS. The study was designed to evaluate the benefit of this strategy by retrospectively comparing for each patient the event‐free survival (EFS) after ASCT with the duration of the disease phase just before the phase including ASCT (ie, the last qualifying phase, LQP). RESULTS. A total of 109 indolent lymphoma (mostly follicular lymphoma) patients were treated with HDT and ASCT. Before ASCT, patients experienced a median of 2 disease phases (range, 1–4). After a median 5‐year follow‐up from ASCT, overall survival was 67% and EFS was 43%. When each of the 92 patients experiencing recurrence was taken as her/his own control, EFS was longer after ASCT than the duration of LQP (62%, P < .01). During LQP, 86 patients (93%) experienced recurrence in less than 5 years, compared with only 58 (63%) who experienced recurrence in the 5 years after ASCT ( P < .01). CONCLUSION. HDT and ASCT can significantly increase EFS in comparison with the duration of the LQP for indolent lymphoma patients and can change disease course. This methodology has been found useful for evaluating new strategies, especially with monoclonal antibodies. Cancer 2007. © 2006 American Cancer Society.