Autologous Transplantation for Diffuse Aggressive Non-Hodgkin’s Lymphoma in Patients Never Achieving Remission: A Report from the Autologous Blood and Marrow Transplant Registry

• DOI: 10.1200/jco.2001.19.2.406
• Publication Date: 2017-02-24T07:36:55Z
• Authors: Julie M. Vose; Mei-Jie Zhang; Philip A. Rowlings; Hillard M. Lazarus; Brian J. Bolwell; Cesar O. Freytes; Santiago Pavlovsky; Armand Keating; Burhan Yanes; Koen van Besien; James O. Armitage; Mary M. Horowitz
• Keywords: Adult; Male; Neoplasm, Residual; Adolescent; Lymphoma, Non-Hodgkin; Remission Induction; Hematopoietic Stem Cell Transplantation; Middle Aged; Combined Modality Therapy; Survival Analysis; Transplantation, Autologous; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Antineoplastic Combined Chemotherapy Protocols; Multivariate Analysis; Humans; Female; Child; Aged; Proportional Hazards Models

PURPOSE: To evaluate the results of high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (autotransplants) in patients with diffuse aggressive non-Hodgkin’s lymphoma (NHL) who never achieve a complete remission conventional chemotherapy. PATIENTS AND METHODS: Detailed records from Autologous Blood Marrow Transplant Registry (ABMTR) on 184 NHL achieved subsequently received an autotransplant were evaluated. Transplants performed between 1989 1995 reported to ABMTR by 48 centers North South America. RESULTS: Seventy-nine (44%) or residual imaging abnormalities unknown significance after autotransplantation. Thirty-four (19%) had partial 55 (31%) no response progressive disease. Eleven (6%) not assessable for because early death. The probabilities progression-free overall survival at 5 years 31% (95% confidence interval [CI], 24% 38%) 37% CI, 30% 45%), respectively. In multivariate analysis, resistance, Karnofsky performance status score less than 80 transplantation, age ≥ receiving three more prior regimens, pre- posttransplant involved-field irradiation therapy adverse prognostic factors survival. CONCLUSION: High-dose should be considered but are still chemotherapy-sensitive otherwise transplant candidates.