[Autologous hematopoietic stem cell transplantation for aggressive B-cell non-Hodgkin's lymphoma].
To evaluate the results of high-dose chemotherapy (HDT) and autologous hematopoietic stem cell transplantation (ASCT) in patients with diffuse B-cell aggressive non-Hodgkin's lymphoma(NHL). Between 1991 and 2004, 25 patients who did not achieve complete remission and 26 in complete remission from conventional chemotherapy received HDC-ASCT. Of 25 patients with refractory NHL,14 were chemotherapy-sensitive before HDT-ASCT and 11 were chemotherapy-resistant. CR was achieved after HDC-ASCT in 50% of 14 chemotherapy sensitive patients and in none of 11 chemotherapy-resistant patients. The 5-year probability of event-free survival for chemotherapy-sensitive and chemotherapy-resistant patients was 51.3% and 20.8%, respectively (p<0.05, log-rank test). Moreover, the 5-year probability of event-free survival for patients in the low-risk group with International Prognostic Index (IPI) and in the high-risk group with IPI was 75.0% and 16.3%, respectively (p<0.05, log-rank test). HDT-ASCT should be considered for patients with refractory aggressive NHL who are chemotherapy-sensitive rather than chemotherapy-resistant. Twenty-six patients in complete remission received consolidation therapy with HDT-ASCT. The 5-year probability of disease-free survival for patients in the low-risk group and in the high-risk group was 68.8% and 60.0%,respectively (p = 0.9 6). HDT-ASCT should be considered for patients at high risk who achieve complete remission after induction treatment. In future, HDT-ASCT combined with rituximab as induction therapy or as consolidation therapy is needed for patients with aggressive NHL in the high-risk group.
Hirose
Asao
A
Clinical Hematology and Clinical Diagnostics, Osaka City University, Graduate School of Medicine.
Yamane
Takahisa
T
Nakajima
Yasuhiro
Y
Manabe
Masahiro
M
Kanashima
Hiroshi
H
Hagihara
Kiyoyuki
K
Sakamoto
Erina
E
Nakamae
Mika
M
Terada
Yoshiki
Y
Kosaka
Saori
S
Aoyama
Yasutaka
Y
Sakamoto
Chikahiko
C
Kumura
Takeo
T
Koh
Ki-Ryang
KR
Hirai
Manabu
M
Ohta
Kensuke
K
Nakao
Yoshitaka
Y
Mugitani
Atsuko
A
Teshima
Hirohumi
H
Hino
Masayuki
M
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000008:administration & dosage; D012074:Remission Induction; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D009607:Nitrosourea Compounds; D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; C020766:ranimustine