title: R-CHOP chemoimmunotherapy followed by autologous transplantation for the treatment of diffuse large B-cell lymphoma.
abstract: BACKGROUND
  We investigated factors that influence outcomes in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab combined with the CHOP regimen (R-CHOP) followed by upfront autologous stem cell transplantation (Auto-SCT).
  
  
  METHODS
  We retrospectively evaluated survival differences between subgroups based on the age-adjusted International Prognostic Index (aaIPI) and revised-IPI (R-IPI) at diagnosis, disease status, and positron emission tomographic/computerized tomographic (PET/CT) status at transplantation in 51 CD20-positive DLBCL patients treated with R-CHOP followed by upfront Auto-SCT.
  
  
  RESULTS
  Patients had either stage I/II bulky disease (5.9%) or stage III/IV disease (94.1%). The median patient age at diagnosis was 47 years (range, 22-66 years); 53.3% and 26.7% had high-intermediate and high risks according to aaIPI, respectively. At the time of Auto-SCT, 72.5% and 27.5% experienced complete (CR) and partial remission (PR) after R-CHOP, respectively. The median time from diagnosis to Auto-SCT was 7.27 months (range, 3.4-13.4 months). The 5-year overall (OS) and progression-free survival (PFS) were 77.3% and 72.4%, respectively. The 5-year OS and PFS rates according to aaIPI, R-IPI, and PET/CT status did not differ between the subgroups. More importantly, the 5-year OS and PFS rates of the patients who achieved PR at the time of Auto-SCT were not inferior to those of the patients who achieved CR (P=0.223 and 0.292, respectively).
  
  
  CONCLUSIONS
  Survival was not influenced by the aaIPI and R-IPI at diagnosis, disease status, or PET/CT status at transplantation, suggesting that upfront Auto-SCT might overcome unfavorable outcomes attributed to PR after induction chemoimmunotherapy.
authors.affiliation: Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Hong Ghi
authors.initials: HG
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Yunsuk
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Sung-Yong
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Yeo-Kyeoung
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
authors.forename: Ho Sup
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, the Catholic University of Korea, Seoul, Korea.
authors.forename: Jeong-A
authors.initials: JA
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hanyang University, Seoul, Korea.
authors.forename: Byeong-Bae
authors.initials: BB
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Gachon University, Incheon, Korea.
authors.forename: Jinny
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea.
authors.forename: Hyeok
authors.initials: H
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, National Cancer Center, Ilsan, Korea.
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Eom
authors.affiliation: Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Junglim
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yonsei University, Seoul, Korea.
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
authors.affiliation: Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.
authors.forename: Keon Woo
authors.initials: KW
authors.lastname: Park
keywords: Autologous transplantation; Diffuse large B-cell lymphoma; Hematopoietic stem cell transplantation; Rituximab; Survival analysis