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Autologous stem cell transplantation may be curative for patients with follicular lymphoma with early therapy failure who reach complete response after rescue treatment
Author(s) -
JiménezUbieto Ana,
Grande Carlos,
Caballero Dolores,
Yáñez Lucrecia,
Novelli Silvana,
HernándezGarcia Miguel Teodoro,
Manzanares María,
Arranz Reyes,
Ferreiro José Javier,
Bobillo Sabela,
Mercadal Santiago,
Galeo Andrea,
Jiménez Javier López,
Moraleda José María,
Vallejo Carlos,
Albo Carmen,
Pérez Elena,
Marrero Carmen,
Magnano Laura,
Palomera Luis,
Jarque Isidro,
MartínezSánchez Pilar,
Martín Alejandro,
Coria Erika,
LópezGuillermo Armando,
Salar Antonio,
Lahuerta Juan José
Publication year - 2018
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2553
Subject(s) - medicine , cohort , rituximab , oncology , autologous stem cell transplantation , follicular lymphoma , transplantation , lymphoma , overall survival , surgery
Patients with follicular lymphoma (FL) who experience early therapy failure (ETF) within 2 years of frontline immunochemotherapy have poor overall survival (OS). We analyzed the Grupo Español de Linfomas y Trasplantes de Médula Ósea registry to determine whether autologous stem cell transplantation (ASCT) is effective in this high‐risk subgroup. Patients with non‐transformed FL treated with rituximab were included in the analysis. ETF was defined as relapse/progression within 2 years of starting first‐line therapy. We identified two groups: the ETF cohort ( n = 52; 38 transplanted in second complete response [CR2] and 14 transplanted in second partial response [PR2]), and the non‐ETF cohort (patients receiving ASCT in either CR2 [ n = 14] or PR2 [ n = 2], but who did not experience ETF following first‐line therapy). There were no differences in 5‐year progression‐free survival (PFS) (49% vs 60%, respectively, P = 0.49) nor in 5‐year OS (81% vs 83%, respectively, P = 0.8) between the ETF and non‐ETF cohorts. Moreover, in the subgroup of patients who presented an interval from first relapse after primary treatment to ASCT of <1 year, there were neither differences in terms of PFS (49% vs 66%, respectively, P = 0.44) nor in OS (86% vs 85%, respectively, P = 0.9) between both cohorts. Patients in the ETF cohort transplanted in CR showed a plateau in the PFS curves beyond 7 years of follow‐up, at 50%. Patients presenting ETF after frontline therapy lack standard therapeutic options. ASCT may be a curative option for ETF in patients who respond to rescue treatments and should be considered an early consolidation option.