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Early Failure of Frontline Rituximab-Containing Chemo-immunotherapy in Diffuse Large B Cell Lymphoma Does Not Predict Futility of Autologous Hematopoietic Cell Transplantation

Hamadani, Mehdi ; Hari, Parameswaran N ; Zhang, Ying ; Carreras, Jeanette ; Akpek, Görgün ; Aljurf, Mahmoud D ; Ayala, Ernesto ; Bachanova, Veronika ; Chen, Andy I ; Chen, Yi-Bin ; Costa, Luciano J ; Fenske, Timothy S ; Freytes, César O ; Ganguly, Siddhartha ; Hertzberg, Mark S ; Holmberg, Leona A ; Inwards, David J ; Kamble, Rammurti T ; Kanfer, Edward J ; Lazarus, Hillard M ; Marks, David I ; Nishihori, Taiga ; Olsson, Richard ; Reddy, Nishitha M ; Rizzieri, David A ; Savani, Bipin N ; Solh, Melhem ; Vose, Julie M ; Wirk, Baldeep ; Maloney, David G ; Smith, Sonali M ; Montoto, Silvia ; Saber, Wael

Biology of blood and marrow transplantation, 2014-11, Vol.20 (11), p.1729-1736

United States: Elsevier Inc

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Título:
Early Failure of Frontline Rituximab-Containing Chemo-immunotherapy in Diffuse Large B Cell Lymphoma Does Not Predict Futility of Autologous Hematopoietic Cell Transplantation
Autor: Hamadani, Mehdi ; Hari, Parameswaran N ; Zhang, Ying ; Carreras, Jeanette ; Akpek, Görgün ; Aljurf, Mahmoud D ; Ayala, Ernesto ; Bachanova, Veronika ; Chen, Andy I ; Chen, Yi-Bin ; Costa, Luciano J ; Fenske, Timothy S ; Freytes, César O ; Ganguly, Siddhartha ; Hertzberg, Mark S ; Holmberg, Leona A ; Inwards, David J ; Kamble, Rammurti T ; Kanfer, Edward J ; Lazarus, Hillard M ; Marks, David I ; Nishihori, Taiga ; Olsson, Richard ; Reddy, Nishitha M ; Rizzieri, David A ; Savani, Bipin N ; Solh, Melhem ; Vose, Julie M ; Wirk, Baldeep ; Maloney, David G ; Smith, Sonali M ; Montoto, Silvia ; Saber, Wael
Assuntos: Adult ; Aged ; Aggressive lymphoma ; Antibodies, Monoclonal, Murine-Derived - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Autologous transplantation ; Cohort Studies ; Diffuse large B cell lymphoma ; Diffuse large B cell lymphoma ; Disease Progression ; Disease-Free Survival ; Early failure ; Female ; Hematology, Oncology and Palliative Medicine ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - methods ; High-dose therapy ; Humans ; Lymphoma, Large B-Cell, Diffuse - drug therapy ; Lymphoma, Large B-Cell, Diffuse - therapy ; Male ; Medicin och hälsovetenskap ; Middle Aged ; Non-Hodgkin lymphoma ; Prognosis ; Rituximab ; Transplantation Conditioning - adverse effects ; Transplantation Conditioning - methods ; Transplantation, Autologous ; Treatment Failure ; Treatment Outcome ; Young Adult
É parte de: Biology of blood and marrow transplantation, 2014-11, Vol.20 (11), p.1729-1736
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SourceType-Scholarly Journals-1
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Descrição: Abstract The poor prognosis for patients with diffuse large B cell lymphoma (DLBCL) who relapse within 1 year of initial diagnosis after first-line rituximab-based chemo-immunotherapy has created controversy about the role of autologous transplantation (HCT) in this setting. We compared autologous HCT outcomes for chemosensitive DLBCL patients between 2000 and 2011 in 2 cohorts based on time to relapse from diagnosis. The early rituximab failure (ERF) cohort consisted of patients with primary refractory disease or those with first relapse within 1 year of initial diagnosis. The ERF cohort was compared with those relapsing >1 year after initial diagnosis (late rituximab failure [LRF] cohort). ERF and LRF cohorts included 300 and 216 patients, respectively. Nonrelapse mortality (NRM), progression/relapse, progression-free survival (PFS), and overall survival (OS) of ERF versus LRF cohorts at 3 years were 9% (95% confidence interval [CI], 6% to 13%) versus 9% (95% CI, 5% to 13%), 47% (95% CI, 41% to 52%) versus 39% (95% CI, 33% to 46%), 44% (95% CI, 38% to 50%) versus 52% (95% CI, 45% to 59%), and 50% (95% CI, 44% to 56%) versus 67% (95% CI, 60% to 74%), respectively. On multivariate analysis, ERF was not associated with higher NRM (relative risk [RR], 1.31; P = .34). The ERF cohort had a higher risk of treatment failure (progression/relapse or death) (RR, 2.08; P < .001) and overall mortality (RR, 3.75; P <. 001) within the first 9 months after autologous HCT. Beyond this period, PFS and OS were not significantly different between the ERF and LRF cohorts. Autologous HCT provides durable disease control to a sizeable subset of DLBCL despite ERF (3-year PFS, 44%) and remains the standard-of-care in chemosensitive DLBCL regardless of the timing of disease relapse.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Early Failure of Frontline Rituximab-Containing Chemo-immunotherapy in Diffuse Large B Cell Lymphoma Does Not Predict Futility of Autologous Hematopoietic Cell Transplantation

United States: Elsevier Inc

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