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  • Hamadani, Mehdi (author)

Early Failure of Frontline Rituximab-Containing Chemo-immunotherapy in Diffuse Large B Cell Lymphoma Does Not Predict Futility of Autologous Hematopoietic Cell Transplantation

  • Article/chapterEnglish2014

Publisher, publication year, extent ...

  • Elsevier BV,2014
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-236521
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-236521URI
  • https://doi.org/10.1016/j.bbmt.2014.06.036DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:129910946URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • The poor prognosis for patients with diffuse large B cell lymphoma (DLBCL) who relapse within 1 year of initial diagnosis after first-line rituximab-based chemo-immunotherapy has created controversy about the role of autologous transplantation (HCT) in this setting. We compared autologous HCT outcomes for chemosensitive DLBCL patients between 2000 and 2011 in 2 cohorts based on time to relapse from diagnosis. The early rituximab failure (ERF) cohort consisted of patients with primary refractory disease or those with first relapse within 1 year of initial diagnosis. The ERF cohort was compared with those relapsing >1 year after initial diagnosis (late rituximab failure [LRF] cohort). ERF and LRF cohorts included 300 and 216 patients, respectively. Nonrelapse mortality (NRM), progression/relapse, progression-free survival (PFS), and overall survival (OS) of ERF versus LRF cohorts at 3 years were 9% (95% confidence interval [CI], 6% to 13%) versus 9% (95% CI, 5% to 13%), 47% (95% CI, 41% to 52%) versus 39% (95% CI, 33% to 46%), 44% (95% CI, 38% to 50%) versus 52% (95% CI, 45% to 59%), and 50% (95% CI, 44% to 56%) versus 67% (95% CI, 60% to 74%), respectively. On multivariate analysis, ERF was not associated with higher NRM (relative risk [RR], 1.31; P = .34). The ERF cohort had a higher risk of treatment failure (progression/relapse or death) (RR, 2.08; P < .001) and overall mortality (RR, 3.75; P < .001) within the first 9 months after autologous HCT. Beyond this period, PFS and OS were not significantly different between the ERF and LRF cohorts. Autologous HCT provides durable disease control to a sizeable subset of DLBCL despite ERF (3-year PFS, 44%) and remains the standard-of-care in chemosensitive DLBCL regardless of the timing of disease relapse.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Hari, Parameswaran N. (author)
  • Zhang, Ying (author)
  • Carreras, Jeanette (author)
  • Akpek, Goerguen (author)
  • Aljurf, Mahmoud D. (author)
  • Ayala, Ernesto (author)
  • Bachanova, Veronika (author)
  • Chen, Andy I. (author)
  • Chen, Yi-Bin (author)
  • Costa, Luciano J. (author)
  • Fenske, Timothy S. (author)
  • Freytes, Cesar O. (author)
  • Ganguly, Siddhartha (author)
  • Hertzberg, Mark S. (author)
  • Holmberg, Leona A. (author)
  • Inwards, David J. (author)
  • Kamble, Rammurti T. (author)
  • Kanfer, Edward J. (author)
  • Lazarus, Hillard M. (author)
  • Marks, David I. (author)
  • Nishihori, Taiga (author)
  • Olsson, RichardKarolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD)(Swepub:uu)riols677 (author)
  • Reddy, Nishitha M. (author)
  • Rizzieri, David A. (author)
  • Savani, Bipin N. (author)
  • Solh, Melhem (author)
  • Vose, Julie M. (author)
  • Wirk, Baldeep (author)
  • Maloney, David G. (author)
  • Smith, Sonali M. (author)
  • Montoto, Silvia (author)
  • Saber, Wael (author)
  • Uppsala universitetCentrum för klinisk forskning i Sörmland (CKFD) (creator_code:org_t)

Related titles

  • In:Biology of blood and marrow transplantation: Elsevier BV20:11, s. 1729-17361083-87911523-6536

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