Outcomes of Transplant-Eligible Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma After Second-Line Salvage Chemotherapy: The Gustave Roussy Experience.
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ pharmacology
Combined Modality Therapy
/ methods
Drug Resistance, Neoplasm
Female
Hematopoietic Stem Cell Transplantation
/ statistics & numerical data
Humans
Lymphoma, Large B-Cell, Diffuse
/ immunology
Male
Middle Aged
Neoplasm Recurrence, Local
/ immunology
Progression-Free Survival
Prospective Studies
Retrospective Studies
Salvage Therapy
/ methods
Transplantation, Autologous
/ statistics & numerical data
Young Adult
Refractory lymphoma
Relapsed lymphoma
Salvage therapy
Journal
Clinical lymphoma, myeloma & leukemia
ISSN: 2152-2669
Titre abrégé: Clin Lymphoma Myeloma Leuk
Pays: United States
ID NLM: 101525386
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
21
09
2020
revised:
05
11
2020
accepted:
07
11
2020
pubmed:
6
12
2020
medline:
11
1
2022
entrez:
5
12
2020
Statut:
ppublish
Résumé
After failure of frontline therapy, patients with relapsed/refractory diffuse large B-cell lymphoma (RR-DLBCL) that does not respond to first-line salvage chemotherapy can be recommended second-line salvage chemotherapy. The available literature in this regard is weak, although many centers routinely offer this type of second-line salvage chemotherapy to their patients. This retrospective study included transplant-eligible patients with RR-DLBCL treated at Gustave Roussy between January 2008 and April 2020. Eligible patients were those who received second-line salvage chemotherapy using R-DHAP or R-ICE in patients who experienced an insufficient partial response, stable disease, or progressive disease in response to first-line salvage chemoimmunotherapy using an alternative regimen. Forty-six RR-DLBCL patients received second-line salvage regimen, which yielded an objective response rate of 33%, median progression-free survival of 2.1 months, and overall survival of 11.4 months. Twelve patients proceeded to autologous stem-cell transplantation (ASCT), of whom 70% remained alive 1 year after ASCT. To explore the impact of transplantation, a multivariate analysis (excluding response to the first-line salvage regimen because this covariate was totally embedded within the transplantation covariate), ASCT was associated with progression-free survival (hazard ratio = 0.16; 95% confidence interval, 0.06-0.42) and overall survival (hazard ratio = 0.27; 95% confidence interval, 0.08-0.88). Second-line salvage chemotherapy with R-DHAP or R-ICE followed by ASCT leads to a favorable outcome in almost one third of patients with RR-DLBCL and offers a median overall survival of approximately 1 year. These data support the administration of second-line salvage chemotherapy followed by ASCT.
Identifiants
pubmed: 33277224
pii: S2152-2650(20)30632-7
doi: 10.1016/j.clml.2020.11.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e373-e380Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.