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Autografting

Long-term follow-up of patients with diffuse large B-cell non-Hodgkin's lymphoma receiving purged autografts after induction failure

Bone Marrow Transplantation volume 45, pages 303–309 (2010)Cite this article

Abstract

Patients with diffuse large B-cell lymphoma (DLBCL) who do not achieve a complete response to front-line combination chemotherapy are often offered high-dose therapy and autologous hematopoietic cell transplantation (AHCT). However, the efficacy of this therapy in this patient population has been addressed in only a few published reports. We retrospectively analyzed the outcomes of patients with a diagnosis of de novo DLBCL who underwent AHCT at our center between 1988 and 2002, and identified 43 consecutive patients who had not achieved a CR before AHCT, although most showed at least a partial response (PR) to either induction or subsequent salvage chemotherapy. A total of 15 patients received a conditioning regimen that included high-dose chemotherapy with fractionated TBI (FTBI), whereas 28 patients received high-dose chemotherapy only. All autografts were treated ex vivo with MoAbs and complement in an effort to remove any residual malignant B cells. A total of 33 (77%) patients achieved a CR after AHCT. With a median follow-up of 7.3 years, the 5-year OS was 69% and EFS was 59%. Four patients died from non-relapse mortality. By univariate analyses, the following characteristics did not significantly impact OS: disease stage at diagnosis, age-adjusted IPI (International Prognostic Index) score, age ⩾40 years, earlier radiotherapy and the use of FTBI in the conditioning regimen. These results confirm the long-term efficacy of AHCT for patients with DLBCL after induction failure.

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Acknowledgements

This study was supported in part by grant, P01-CA 49605, from the National Institutes of Health, Bethesda, MD, USA.

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Authors and Affiliations

  1. Division of Blood and Marrow Transplantation, Stanford University, Stanford, CA, USA

    J E Benjamin, G L Chen, T M Cao, P D Cao, R M Wong, K Sheehan, J A Shizuru, L J Johnston, R S Negrin, R Lowsky & G G Laport

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  1. J E Benjamin
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  2. G L Chen
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  3. T M Cao
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Correspondence to J E Benjamin.

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Benjamin, J., Chen, G., Cao, T. et al. Long-term follow-up of patients with diffuse large B-cell non-Hodgkin's lymphoma receiving purged autografts after induction failure. Bone Marrow Transplant 45, 303–309 (2010). https://doi.org/10.1038/bmt.2009.152

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