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Clinical Trial
. 2019 Apr;98(4):823-831.
doi: 10.1007/s00277-019-03605-1. Epub 2019 Feb 4.

High-dose etoposide could discriminate the benefit from autologous peripheral blood stem cell transplantation in the patients with refractory diffuse large B cell lymphoma

Yu Cai  1 , Liping Wan  1 , Juan Yang  1 , Jun Zhu  1 , Jieling Jiang  1 , Su Li  1 , Xianmin Song  2 , Chun Wang  3
Affiliations
Clinical Trial

High-dose etoposide could discriminate the benefit from autologous peripheral blood stem cell transplantation in the patients with refractory diffuse large B cell lymphoma

Yu Cai et al. Ann Hematol. 2019 Apr.

Abstract

To evaluate the strategy of using high-dose etoposide mobilization followed by autologous peripheral blood stem cell transplantation (APBSCT) in patients with diffuse large B cell lymphoma (DLBCL) refractory to rituximab-based chemotherapy. Forty patients with refractory DLBCL were treated with high-dose etoposide for stem cell mobilization. All patients were in progressive disease (PD) prior to mobilization and underwent high-dose chemotherapy followed by APBSCT. Successful PBSC mobilization was achieved in all patients. Twenty-three patients (57.5%) showed a clinical response to high-dose etoposide. After APBSCT, 17 patients (42.5%) achieved CR. The 2-year progression-free (PFS) and overall survival (OS) rate were higher in patients responding to high-dose etoposide (64.1% and 77.7%) compared to those without response (11.8% and 11.8%; P < 0.001 for both). The response to high-dose etoposide mobilization therapy was an independent prognostic factor for CR achievement, PFS and OS after APBSCT. High-dose etoposide mobilization chemotherapy followed by APBSCT could rescue a proportion of patients with refractory DLBCL who responded to etoposide mobilization regimen.

Keywords: Autologous peripheral blood stem cell transplantation; Diffuse large B cell lymphoma; High-dose etoposide; Refractory.

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Conflict of interest statement

The authors report no conflicts of interest. The authors are responsible for the content and writing of this article.

Figures

Fig. 1
Fig. 1
Consort diagram of patient distribution
Fig. 2
Fig. 2
a Kaplan–Meier product estimate of the cumulative probability of progression-free survival (PFS) in patients (n = 40). b Kaplan–Meier product estimate of the cumulative probability of overall survival (OS) in patients (n = 40)
Fig. 3
Fig. 3
a Kaplan–Meier product estimate of the cumulative probability of progression-free survival (PFS) in patients who had response (n = 23) or no response to etoposide (n = 17). b Kaplan–Meier product estimate of the cumulative probability of overall survival (OS) in patients who had response (n = 23) or no response to etoposide (n = 17)
See this image and copyright information in PMC

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