title: High dose chemotherapy with autologous stem cell transplant for patients with transformed B-cell non-Hodgkin lymphoma in the rituximab era.
abstract: High dose chemotherapy with autologous stem cell transplant (HD-ASCT) is a recommended procedure for patients with transformed indolent B-cell lymphoma from the pre-rituximab era. In this retrospective single-center study, we present our experience with HD-ASCT in patients with histologically verified transformed indolent B-cell lymphoma in the rituximab era. Forty-two patients were included, of whom 28 with chemosensitive disease proceeded to HD-ASCT. Twenty patients (71%) achieved a complete response (CR) and five (18%) a partial response (PR) after HD-ASCT. With a median observation time of 49 months for the survivors, the median progression-free survival (PFS) and overall survival (OS) for patients with HD-ASCT were 39 months and 57 months, respectively. Patients who were rituximab-naive at transformation had a significantly better OS compared to patients previously treated with rituximab, both in the whole patient cohort and among the HD-ASCT-treated patients (p = 0.036 and p = 0.039, respectively). Furthermore, male sex influenced survival negatively, whereas time from diagnosis to transformation was positively associated with survival, both with borderline significance, in HD-ASCT-treated patients. In conclusion, HD-ASCT remains an effective treatment for transformed indolent lymphomas in the rituximab era.
authors.affiliation: Center for Cancer Biomedicine, Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Yngvild N
authors.initials: YN
authors.lastname: Blaker
authors.forename: Marianne B
authors.initials: MB
authors.lastname: Eide
authors.forename: Knut
authors.initials: K
authors.lastname: Liestøl
authors.forename: Grete F
authors.initials: GF
authors.lastname: Lauritzsen
authors.forename: Arne
authors.initials: A
authors.lastname: Kolstad
authors.forename: Alexander
authors.initials: A
authors.lastname: Fosså
authors.forename: Erlend B
authors.initials: EB
authors.lastname: Smeland
authors.forename: Harald
authors.initials: H
authors.lastname: Holte
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab
keywords: High dose therapy; malignant lymphoma; stem cell transplant