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Salvage Regimens Wi...
Salvage Regimens With Autologous Transplantation for Relapsed Large B-Cell Lymphoma in the Rituximab Era
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Gisselbrecht, Christian (författare)
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Glass, Bertram (författare)
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Mounier, Nicolas (författare)
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Gill, Devinder Singh (författare)
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Linch, David C. (författare)
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Trneny, Marek (författare)
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Bosly, Andre (författare)
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Ketterer, Nicolas (författare)
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Shpilberg, Ofer (författare)
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- Hagberg, Hans (författare)
- Uppsala universitet,Enheten för onkologi
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Ma, David (författare)
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Briere, Josette (författare)
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Moskowitz, Craig H. (författare)
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Schmitz, Norbert (författare)
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(creator_code:org_t)
- 2010
- 2010
- Engelska.
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Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 28:27, s. 4184-4190
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Purpose Salvage chemotherapy followed by high-dose therapy and autologous stem-cell transplantation (ASCT) is the standard treatment for relapsed diffuse large B-cell lymphoma (DLBCL). Salvage regimens have never been compared; their efficacy in the rituximab era is unknown. Patients and Methods Patients with CD20(+) DLBCL in first relapse or who were refractory after first-line therapy were randomly assigned to either rituximab, ifosfamide, etoposide, and carboplatin (R-ICE) or rituximab, dexamethasone, high-dose cytarabine, and cisplatin (R-DHAP). Responding patients received high-dose chemotherapy and ASCT. Results The median age of the 396 patients enrolled (R-ICE, n = 202; R-DHAP, n = 194) was 55 years. Similar response rates were observed after three cycles of R-ICE (63.5%; 95% CI, 56% to 70%) and R-DHAP (62.8%; 95 CI, 55% to 69%). Factors affecting response rates (P < .001) were refractory disease/relapse less than versus more than 12 months after diagnosis (46% v 88%, respectively), International Prognostic Index (IPI) of more than 1 versus 0 to 1 (52% v 71%, respectively), and prior rituximab treatment versus no prior rituximab (51% v 83%, respectively). There was no significant difference between R-ICE and R-DHAP for 3-year event-free survival (EFS) or overall survival. Three-year EFS was affected by prior rituximab treatment versus no rituximab (21% v 47%, respectively), relapse less than versus more than 12 months after diagnosis (20% v 45%, respectively), and IPI of 2 to 3 versus 0 to 1 (18% v 40%, respectively). In the Cox model, these parameters were significant (P < .001). Conclusion In patients who experience relapse more than 12 months after diagnosis, prior rituximab treatment does not affect EFS. Patients with early relapses after rituximab-containing first-line therapy have a poor prognosis, with no difference between the effects of R-ICE and R-DHAP.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Oncology
- Onkologi
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Gisselbrecht, Ch ...
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Glass, Bertram
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Mounier, Nicolas
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Gill, Devinder S ...
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Linch, David C.
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Trneny, Marek
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visa fler...
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Bosly, Andre
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Ketterer, Nicola ...
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Shpilberg, Ofer
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Hagberg, Hans
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Ma, David
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Briere, Josette
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Moskowitz, Craig ...
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Schmitz, Norbert
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visa färre...
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