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LACE‐conditioned autologous stem cell transplantation for relapsed or refractory diffuse large B‐cell lymphoma: treatment outcome and risk factor analysis from a single centre
Author(s) -
Pavlů Jiří,
Auner Holger W.,
Ellis Sarah,
Szydlo Richard M.,
Giles Chrissy,
Contento Alejandro,
Rahemtulla Amin,
Apperley Jane F.,
Naresh Kikkeri,
MacDonald Donald H.,
Kanfer Edward J.
Publication year - 2011
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.956
Subject(s) - medicine , autologous stem cell transplantation , lomustine , etoposide , oncology , diffuse large b cell lymphoma , cytarabine , lymphoma , carmustine , transplantation , chemotherapy , refractory (planetary science) , cyclophosphamide , gastroenterology , surgery , vincristine , astrobiology , physics
High‐dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a recognized treatment option for patients with relapsed diffuse large B‐cell lymphoma. We have analysed 51 patients who underwent ASCT after LACE (lomustine (CCNU), cytarabine (Ara‐C), cyclophosphamide, etoposide) conditioning for relapsed ( n = 34, 67%) or primary refractory ( n = 17, 33%) diffuse large B‐cell lymphoma. With a median follow‐up of 60 months (range 2–216) the probabilities of overall survival (OS) and progression‐free survival (PFS) at 5 years were 47 and 42%, respectively. The cumulative treatment‐related mortality was 10% ( n = 5). Probabilities for OS and PFS at 5 years were 56 and 50% for patients with chemosensitive and 29 and 27% for patients with chemorefractory disease. In multivariate analysis abnormal pre‐ASCT levels of C‐reactive protein (>5 mg/L) were identified as a risk factor for worse OS, whereas abnormal pre‐ASCT levels of C‐reactive protein and chemoresistance predicted inferior PFS. LACE followed by ASCT is an effective treatment for approximately half of patients with chemosensitive relapsed diffuse large B‐cell lymphoma, and a proportion of chemorefractory patients also benefit. Copyright © 2010 John Wiley & Sons, Ltd.