High dose chemotherapy and autologous stem cell transplantation in non-Hodgkin's lymphoma: an eight-year experience

Abstract

Autologous stem cell transplantation (ASCT) is commonly used in relapsed or refractory non-Hodgkin's lymphoma (NHL). Several trials report the role of ASCT for high risk patients. We evaluated the results and the prognostic factors influencing the therapeutic effects on the patients who were treated with high dose chemotherapy (HDC) and autologous peripheral stem cell transplantation. We analyzed the data of 40 cases with NHL who underwent ASCT after HDC. Twenty- four patients had high-risk disease, 12 cases sensitive relapse, and two cases resistant relapse or primary refractory each. The median age of patients was 34 years (range, 14-58 years). The median follow-up duration from transplantation was 16 months (range, 0.6-94 months). Estimated overall survival and progression-free survival at 5 years were 40% and 30%, respectively. Poor prognostic factors for survival included older age (>/= 45 years), poor performance status in all patient analysis, and a longer interval between first complete remission and transplantation in high risk patients. In high risk NHL patients, transplantation should be done early after first complete remission to overcome chemo-resistance.

Fig. 1

Overall survival (-) and progression free survival (---) rates of all patients.

Fig. 2

(A) Overall survival rates according to disease status at transplantation. High risk vs. Resistant relapse, p = 0.37; Sensitive relapse vs. Resistant relapse, p = 0.68. (B) Progression free survival rates according to disease status at transplantation. High risk vs. Resistant relapse, p = 0.59; Sensitive relapse vs. Resistant relapse, p = 0.85.

Fig. 3

Overall survival rates according to interval from CR to transplantation in high risk patients.