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Disease staging with positron emission tomography or gallium scanning and use of rituximab predict outcome for patients with diffuse large B‐cell lymphoma treated with autologous stem cell transplantation
Author(s) -
Alousi Amin M.,
Saliba Rima M.,
Okoroji GraceJulia,
Macapinlac Homer A.,
Hosing Chitra,
Korbling Martin,
Samuels Barry I.,
Popat Uday,
Kebriaei Partow,
Anderlini Paolo,
Qazilbash Muzaffar H.,
De Lima Marcos,
Giralt Sergio A.,
Champlin Richard E.,
Khouri Issa F.
Publication year - 2008
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2008.07277.x
Subject(s) - rituximab , medicine , autologous stem cell transplantation , diffuse large b cell lymphoma , transplantation , oncology , positron emission tomography , hazard ratio , lymphoma , nuclear medicine , surgery , confidence interval
Summary Tumor status, as determined by positron emission tomography or gallium scanning (PET/G), may be an important predictor of outcome for patients with diffuse large B‐cell lymphoma (DLBCL) undergoing autologous stem cell transplantation (ASCT). ASCT conditioning regimens that include rituximab may reduce the rate of relapse. We evaluated the influence of rituximab on overall and progression‐free survival in patients with DLBCL based on PET/G status before ASCT. A retrospective review of all patients with chemosensitive DLBCL who underwent ASCT in the context of research protocols at our institution between 1995 and 2005 was performed. Our study included 174 patients. Disease status before ASCT, according to PET/G, was negative in 136 patients (78%), positive in 29 patients (17%), and unknown in nine patients (5%). PET/G status and rituximab use were the only factors predictive of progression‐free survival in multivariate analyses: the hazard ratios for relapse were 2·9 for PET/G‐positive versus ‐negative patients ( P < 0·001) and 0·4 for rituximab versus no rituximab use ( P = 0·001). We conclude that evidence of disease on PET/G scanning prior to transplantation is associated with an increased risk for relapse after ASCT. Transplantation regimens containing rituximab can reduce this risk, regardless of PET/G status.