title: Comparison of outcomes after auto-SCT for patients with relapsed diffuse large B-cell lymphoma according to previous therapy with rituximab.
abstract: The standard approach for relapsed diffuse large B-cell lymphoma (DLBCL) involves auto-SCT. However, studies that established this approach were conducted before the inclusion of rituximab (R) with first-line therapy became routine. Whether DLBCL patients (pts) relapsing after first-line chemoimmunotherapy including R derive a comparable benefit from auto-SCT to pts in the pre-R era is unknown. We analyzed outcomes after auto-SCT for relapsed DLBCL among pts receiving initial R and those who did not. We reviewed 257 consecutive pts with relapsed DLBCL treated at our institution with auto-SCT. In all, 226 pts were included in the analysis, of whom 161 had received no R and 65 received R as part of first-line therapy (Planned R). Median OS and relapse-free survival, measured from transplant, were similar between No R vs Planned R groups: 67 vs 44 months (P=0.3) and 25 vs 27 months (P=0.8), respectively. A further analysis was carried out between two cohorts matched by propensity analysis. Again, no differences in outcomes were observed. This suggests that auto-SCT may be equally effective in pts relapsing after first-line therapy including R, and should remain the standard of care for relapsed DLBCL.
authors.affiliation: Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Cleveland, OH 44195, USA. Smiths11@ccf.org
authors.forename: S D
authors.initials: SD
authors.lastname: Smith
authors.forename: B J
authors.initials: BJ
authors.lastname: Bolwell
authors.forename: L A
authors.initials: LA
authors.lastname: Rybicki
authors.forename: T
authors.initials: T
authors.lastname: Kang
authors.forename: R
authors.initials: R
authors.lastname: Dean
authors.forename: A
authors.initials: A
authors.lastname: Advani
authors.forename: S
authors.initials: S
authors.lastname: Thakkar
authors.forename: R
authors.initials: R
authors.lastname: Sobecks
authors.forename: M
authors.initials: M
authors.lastname: Kalaycio
authors.forename: B
authors.initials: B
authors.lastname: Pohlman
authors.forename: J W
authors.initials: JW
authors.lastname: Sweetenham
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D012189:Retrospective Studies; D000069283:Rituximab; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone