High-dose therapy and autologous stem cell transplant for transformed non-Hodgkin lymphoma in the rituximab era

James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY , USA.
Leukemia & lymphoma (Impact Factor: 2.89). 12/2011; 53(5):830-5. DOI: 10.3109/10428194.2011.631637
Source: PubMed


The impact of rituximab on the outcome of high-dose therapy and autologous stem cell transplant (HD-ASCT) for transformed non-Hodgkin lymphoma (NHL) has not been previously described. We analyzed 18 consecutive patients with indolent NHL who transformed to diffuse large B-cell lymphoma (DLBCL), received rituximab-containing therapy either before or after transformation and underwent subsequent HD-ASCT. With a median follow-up of 40 months, the 2-year progression-free survival (PFS) was 59% and the 2-year overall survival (OS) was 82%. Six patients did not receive rituximab pre-transformation. This group had a significantly better PFS at 2 years post-HD-ASCT compared to 12 patients who were exposed to rituximab pre-transformation (p = 0.03). HD-ASCT remains an effective therapeutic option for transformed NHL in the rituximab era. However, patients exposed to rituximab pre-transformation appear to have inferior HD-ASCT outcomes, and thus may benefit from novel conditioning and maintenance regimens in the setting of HD-ASCT.

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Available from: Laurie A Milner, Apr 10, 2015
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