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Autografting

Time of relapse after initial therapy significantly adds to the prognostic value of the IPI-R in patients with relapsed DLBCL undergoing autologous stem cell transplantation

Bone Marrow Transplantation volume 41, pages 715–720 (2008)Cite this article

Abstract

We explored the concomitant effect of the International Prognostic Index at the time of relapse (IPI-R) and the time from initial diagnosis to relapse (TTR) on outcome of 80 uniformly treated patients receiving BEAM conditioning followed by SCT for relapsed, chemosensitive diffuse large B-cell lymphoma. Median age at the time of transplantation was 62 years (range 26–77). Median follow-up of survivors was 31.4 months. Median overall survival (OS) from the time of transplant for patients with TTR >18 months vs ⩽18 months was not reached and 50 months, respectively (P=0.01). Median OS for patients with IPI-R ⩾3 was 23.3 months and not reached for patients with IPI-R <3 (P=0.01). These factors were independent in multivariate analysis with relative risk for death of 0.91 (0.80–0.99; P=0.04) for each 6-month increment in TTR and 0.63 (0.42–0.96; P=0.03) for IPI-R <3. TTR ⩽18 months and IPI-R ⩾3 were combined in a prognostic system where patients with none (n=32), one (n=39) or two (n=9) of these factors had median OS not reached, of 50 and 5 months, respectively (P<0.01). Patients with early, high IPI-R relapse after first-line therapy have a dismal outcome with SCT and should receive experimental therapies.

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA

    L J Costa, I N Micallef, D J Inwards, P B Johnston, L F Porrata & S M Ansell

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  1. L J Costa
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Costa, L., Micallef, I., Inwards, D. et al. Time of relapse after initial therapy significantly adds to the prognostic value of the IPI-R in patients with relapsed DLBCL undergoing autologous stem cell transplantation. Bone Marrow Transplant 41, 715–720 (2008). https://doi.org/10.1038/sj.bmt.1705967

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