title: Outcomes of diffuse large B-cell lymphoma patients relapsing after autologous stem cell transplantation: an analysis of patients included in the CORAL study.
abstract: In the CORAL study, 255 chemosensitive relapses with diffuse large B-cell lymphoma (DLBCL) were consolidated with autologous stem cell transplantation (ASCT), and 75 of them relapsed thereafter. The median time between ASCT and progression was 7.1 months. The median age was 56.1 years; tertiary International Prognosis Index (tIPI) observed at relapse was 0-2 in 71.6% of the patients and >2 in 28.4%. The overall response rate to third-line chemotherapy was 44%. The median overall survival (OS) was 10.0 months (median follow-up: 32.8 months). Thirteen patients received an allogeneic SCT, and three a second ASCT. The median OS was shorter among patients who relapsed <6 months (5.7 months) compared with those relapsing ⩾12 months after ASCT (12.6 months, P=0.0221). The median OS in patients achieving CR, PR or no response after the third-line regimen was 37.7 (P<0.0001), 10.0 (P=0.03) and 6.3 months, respectively. The median OS varied according to tIPI: 0-2: 12.6 months and >2: 5.3 months (P=0.0007). In multivariate analysis, tIPI >2, achievement of response and remission lasting <6 months predicted the OS. This report identifies the prognostic factors for DLBCL relapsing after ASCT and thus helps to select patients for experimental therapy.
authors.affiliation: Cliniques Universitaires UCL Saint-Luc, Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Van Den Neste
authors.affiliation: AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Schmitz
authors.affiliation: CHU de l'Archet, route de St Antoine-Ginestiere, Nice, France.
authors.forename: N
authors.initials: N
authors.lastname: Mounier
authors.affiliation: Princess Alexandra Hospital, Woodville, South Australia, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Gill
authors.affiliation: University College London, Cancer Institute, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Linch
authors.affiliation: Charles University and General Hospital, Praha, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Trneny
authors.affiliation: Institut Paoli Calmette Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Bouadballah
authors.affiliation: University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: J
authors.initials: J
authors.lastname: Radford
authors.affiliation: Hämatologie, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Bargetzi
authors.affiliation: Institut Gustave Roussy, Villejuif, France.
authors.forename: V
authors.initials: V
authors.lastname: Ribrag
authors.affiliation: Universitätsklinikum Essen, KlinikfürHämatologie-Hufelandstraße, Essen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Dührsen
authors.affiliation: St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Ma
authors.affiliation: Hopital Saint Louis Paris, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Briere
authors.affiliation: Hopital Saint Louis Paris, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Thieblemont
authors.affiliation: Hospices Civils de Lyon, Université de Lyon, Pierre Benite, France.
authors.forename: E
authors.initials: E
authors.lastname: Bachy
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Moskowitz
authors.affiliation: AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Glass
authors.affiliation: Hopital Saint Louis Paris, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Gisselbrecht
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064592:Autografts; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D033581:Stem Cell Transplantation; D015996:Survival Rate