Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation

Man Hsin Hung, Yuan Bin Yu, Yu Chung Huang, Han Tsung Liu, Ying Chung Hong, Liang Tsai Hsiao, Jin Hwang Liu, Jyh Pyng Gau, Tzeon Jye Chiou, Po Min Chen, Cheng Hwai Tzeng, Chun Yu Liu

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Certain portions of patientswith diffuse large B cell lymphoma (DLBCL) do not achieve a complete remission after first-line rituximab combining chemotherapy. This retrospective study aimed to characterize the outcome of patients with DLBCL that achieved partial remission or had stable disease after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The effects of subsequent treatments and factors associated with eventfree survival (EFS) after second-line treatments were analyzed. A total of 103 patients were enrolled and 81 (76.8 %) patients received intensive chemotherapy, whereas the others (23.2 %) received either palliative chemotherapy or supportive care post first-line treatment. Patients receiving intensive chemotherapy had significantly higher EFS (median 7.9 months) than the others; 28 (34.6 %) patients in this group received autologous stem cell transplantation (ASCT), which may have further improved the EFS. An International Prognostic Index (IPI) >2 and absolute lymphocyte count (ALC) at diagnosis <1,000/UL were significant prognostic factors associated with worse EFS. The survival advantage of ASCT remained significant after adjustment for these factors. The results suggest intensive chemotherapy plus ASCT may provide modest disease control in patients with DLBCL who achieve PR or SD to first-line R-CHOP, particularly in those with a higher IPI score and/or low ALC at diagnosis.

Original languageEnglish
Pages (from-to)1907-1915
Number of pages9
JournalAnnals of Hematology
Volume91
Issue number12
DOIs
Publication statusPublished - Dec 2012
Externally publishedYes

Keywords

  • Absolute lymphocyte count
  • Autologous stem cell transplantation
  • Incomplete response
  • Non-Hodgkin's lymphoma (NHL)
  • Rituximab

ASJC Scopus subject areas

  • Hematology

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