title: Allogeneic stem cell transplantation in patients with de novo diffuse large B-cell lymphoma who experienced relapse or progression after autologous stem cell transplantation: a Korea-Japan collaborative study.
abstract: Patients with diffuse large B-cell lymphoma (DLBCL) who failed autologous stem cell transplantation (auto-SCT) generally have a poor prognosis. Allogeneic stem cell transplantation (allo-SCT) has been implemented to overcome this problem. We report clinical outcomes of allo-SCT in patients with de novo DLBCL who failed auto-SCT from four hospitals in Korea and Japan. Thirty patients were included. The median age was 39 (range, 22-59) years. The 5-year event-free survival (EFS) and overall survival (OS) after allo-SCT were 37.9 % and 42.6 %, respectively. There was only a single event beyond 12 months in the Kaplan-Meier curve of EFS. Non-relapse mortality (NRM) was reported in five patients (16.7 %). In the multivariate analysis, the risk factors for EFS were prior chemotherapy lines ≥ 5 (p = 0.010) and chemo-resistant disease (p = 0.007). The risk factors for OS were chemo-resistant disease (p = 0.024) and Eastern Cooperative Oncology Group performance status 2 (p = 0.005). NRM was associated with prior chemotherapy lines ≥ 5 (p = 0.042), chemo-resistant disease (p = 0.009), and poor performance status (p < 0.001). In conclusion, allo-SCT showed considerable efficacy in patients with DLBCL whose disease was relapsed or progressed after auto-SCT. Our data suggest that allo-SCT could be a viable treatment option if patients have fewer lines of prior chemotherapy, chemo-sensitive disease, and/or good PS.
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Kohei
authors.initials: K
authors.lastname: Tada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kwon
authors.forename: Soo-Mee
authors.initials: SM
authors.lastname: Bang
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Seonyang
authors.initials: S
authors.lastname: Park
mesh_terms: D000328:Adult; D064591:Allografts; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012008:Recurrence; D012086:Reoperation; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D016019:Survival Analysis; D014182:Transplantation, Autologous; D055815:Young Adult