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. 2024 Apr 10;6(2):21-30.
doi: 10.46989/001c.115919. eCollection 2024.

Outcomes of Autologous stem cell transplantation in patients with primary refractory Diffuse Large B-cell lymphoma who demonstrate chemosensitivity to salvage chemotherapy

M Shahzad Rauf  1 , Irfan Maghfoor  1 , Muhammad Aseafan  1 , Khadijah Al Shankati  1 , Ali M Alhanash  1 , Faateh Sohail  2 , Tusneem A M Elhassan  1 , Saad Akhtar  1
Affiliations

Outcomes of Autologous stem cell transplantation in patients with primary refractory Diffuse Large B-cell lymphoma who demonstrate chemosensitivity to salvage chemotherapy

M Shahzad Rauf et al. Clin Hematol Int. .

Abstract

Rituximab with anthracycline-based combination frontline chemoimmunotherapy can cure 50-60% of patients with diffuse large B-cell lymphoma (DLBCL). However, studies on the outcomes of patients with DLBCL who experience partial response (PR), stable or progressive disease in response to frontline rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) therapy are limited, as are data on the outcomes of high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) in patients with primary refractory DLBCL who demonstrate chemosensitivity to salvage chemotherapy (SC). We assessed the latter among 184 patients, 144 of whom started SC, with 84 responding and 72 receiving HDC-ASCT. The 5-year survival rate was 58.9%; the median overall survival (OS) was not reached. The difference in response to SC (partial response versus complete response) was significant, with higher 2- and 5-year OS rates in patients with CR (78.1% and 74.9%, respectively) than in those with PR (55.3% and 47%, respectively). The median OS for the whole group was 15 months and particularly patients who had progressive disease after frontline R-CHOP had dismal outcomes. Our study suggests that in patients with primary refractory DLBCL without initial progressive disease after frontline R-CHOP, the depth of response to SC before HDC-ASCT is predictive of relapse.

Keywords: Middle East; autologous stem cell transplantation; diffuse large B-cell lymphoma outcomes; salvage chemotherapy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.. Survival curves were compared using the log-rank test. A multivariate Cox proportional hazards regression model was utilized to identify risk factors associated with OS.
See this image and copyright information in PMC

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