title: Outcome of patients with transformed indolent non-Hodgkin lymphoma referred for autologous stem-cell transplantation.
abstract: BACKGROUND
  The proportion of potentially eligible patients with transformed indolent non-Hodgkin lymphoma who undergo autologous stem-cell transplantation (ASCT) is unknown. There are limited data describing their outcome in the rituximab era.
  
  
  METHODS
  We reviewed 105 consecutive patients with biopsy-proven transformation referred to Princess Margaret Hospital for consideration of ASCT during 1996-2009. Patients received anthracycline or platinum-based chemotherapy with or without rituximab. Responders proceeded to stem-cell mobilization and ASCT.
  
  
  RESULTS
  The median age at transformation was 54 (range 30-65) years. Patients received a median of two chemotherapy regimens for transformation, including rituximab in 39%. Fifty patients (48%) proceeded with ASCT and 55 (52%) did not, mainly due to progressive disease (n = 42). Three-year overall (OS) and progression-free survival (PFS) post-ASCT were 54% and 42%, respectively. Patients receiving rituximab with chemotherapy before transplant had a 3-year post-ASCT OS of 71% versus 47% in those who received chemotherapy alone (P = 0.046). Patients transplanted after 2004 had a 3-year post-ASCT OS of 69% versus 39% in those receiving ASCT earlier (P = 0.009).
  
  
  CONCLUSIONS
  About half of transplant-eligible patients with transformation are able to undergo ASCT. Outcomes following ASCT appear to have improved over recent years, although the role of rituximab in this patient population requires further evaluation.
authors: Autologous Blood and Marrow Transplant Program, Princess Margaret Hospital, Toronto, Ontario, Canada.
authors: D
authors: D
authors: Villa
authors: M
authors: M
authors: Crump
authors: A
authors: A
authors: Keating
authors: T
authors: T
authors: Panzarella
authors: B
authors: B
authors: Feng
authors: J
authors: J
authors: Kuruvilla
mesh_terms: D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000639:trends*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000401:mortality / Q000639:trends*; D015996:Survival Rate / Q000639:trends; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: autologous transplant; rituximab; transformed lymphoma