Contributions
Abstract: PB2421
Type: Publication Only
Background
Diffuse large B-cell lymphoma (DLBCL) is one of the most frequent non-Hodgkin lymphpmas (NHL) accounting for about 30% of all newly diagnosed cases and more than 80% out of aggressive lymphomas. Outcome of initial therapy has improved over the last decade but approximately 10-15% of patients present primary refractory disease and additionally 20-25% out of them will relapse.
Salvage chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) is still the standard second-line treatment for refractory/relapsed DLBCL.
Aims
The aim of the study is to present chemosensitive patients with relapsed/refractory DLBCL who underwent AHSCT at our centre between December 1997 and October 2017.
Methods
We evaluated 81 patients; there were 35 male and 46 female. Median age was 42.6 years (range; 18.0-69.7) .Most patients were diagnosed as DLBCL NOS-63 pts. (78%), as Primary Mediastinal Large B-cell Lymphoma-12 pts. (15%) , as Primary DLBCL of central nervous system-2 pts. (2%), T-cell /histiocyte –rich large B-cell lymphoma -1 pt.(1%) and as Anaplastic ALK+ large B-cell lymphoma-3 pts. (2%). They received median 2 lines of induction therapies (range; 1-4); most were treated with R-CHOP and R+/R-/-DHAP . 34% patients achieved complete (CR), 53.2% partial remission(PR) and 12.8% had progression before transplantation.
Results
In all 81 patients stem cell collection was performed from peripheral blood (100%). The standard conditioning regimen BEAM(BCNU, Etoposide ,Ara-C and Melphalan) was given to 80 patients , 1 received CBV (BCNU,Cyclophosphamide, Etoposode). A median number of 3.8 CD34+ cells/kg (range; 1.6-8.0) were infused .
All patients were engrafted with a median time to achieve an absolute neutrophil count>0.5x109/L of 12 days (range; 8-36 ) and to platelets>20x10/9/L of 13 days (range: 7-36 ). The complications grade 3 and 4 seen in transplanted patients inculded; mucositis (n=69), bacterial infection (n=5), viral infection (n=4), hemorrhage of CNS in 2 patients (they alive).
Transplant related mortality (TRM) was 6.3%
The overall response rate(OS) was 90%. 62% patients achieved CR, 28% PR and 10% stayed in progrssion after AHSCT.The median overall survival (OS) was 47,1 months (median: 3.13-237.9). The median of disease free survival (DFS) was 40.1 months (median; 2.97-237.9).
Conclusion
Conclusion: AHSCT is highly effective and safe procedure for refractory/relapsed DLBCL patients .Novel agents incorporated in AHSCT programm will be helpful in every part of it; as an induction chemotherapy, preparative regimen and maintenace therapy to improve the results of DLBCL patients , refractory even to AHSCT.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous hematopoietic stem cell transplantation, DLBCL
Abstract: PB2421
Type: Publication Only
Background
Diffuse large B-cell lymphoma (DLBCL) is one of the most frequent non-Hodgkin lymphpmas (NHL) accounting for about 30% of all newly diagnosed cases and more than 80% out of aggressive lymphomas. Outcome of initial therapy has improved over the last decade but approximately 10-15% of patients present primary refractory disease and additionally 20-25% out of them will relapse.
Salvage chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) is still the standard second-line treatment for refractory/relapsed DLBCL.
Aims
The aim of the study is to present chemosensitive patients with relapsed/refractory DLBCL who underwent AHSCT at our centre between December 1997 and October 2017.
Methods
We evaluated 81 patients; there were 35 male and 46 female. Median age was 42.6 years (range; 18.0-69.7) .Most patients were diagnosed as DLBCL NOS-63 pts. (78%), as Primary Mediastinal Large B-cell Lymphoma-12 pts. (15%) , as Primary DLBCL of central nervous system-2 pts. (2%), T-cell /histiocyte –rich large B-cell lymphoma -1 pt.(1%) and as Anaplastic ALK+ large B-cell lymphoma-3 pts. (2%). They received median 2 lines of induction therapies (range; 1-4); most were treated with R-CHOP and R+/R-/-DHAP . 34% patients achieved complete (CR), 53.2% partial remission(PR) and 12.8% had progression before transplantation.
Results
In all 81 patients stem cell collection was performed from peripheral blood (100%). The standard conditioning regimen BEAM(BCNU, Etoposide ,Ara-C and Melphalan) was given to 80 patients , 1 received CBV (BCNU,Cyclophosphamide, Etoposode). A median number of 3.8 CD34+ cells/kg (range; 1.6-8.0) were infused .
All patients were engrafted with a median time to achieve an absolute neutrophil count>0.5x109/L of 12 days (range; 8-36 ) and to platelets>20x10/9/L of 13 days (range: 7-36 ). The complications grade 3 and 4 seen in transplanted patients inculded; mucositis (n=69), bacterial infection (n=5), viral infection (n=4), hemorrhage of CNS in 2 patients (they alive).
Transplant related mortality (TRM) was 6.3%
The overall response rate(OS) was 90%. 62% patients achieved CR, 28% PR and 10% stayed in progrssion after AHSCT.The median overall survival (OS) was 47,1 months (median: 3.13-237.9). The median of disease free survival (DFS) was 40.1 months (median; 2.97-237.9).
Conclusion
Conclusion: AHSCT is highly effective and safe procedure for refractory/relapsed DLBCL patients .Novel agents incorporated in AHSCT programm will be helpful in every part of it; as an induction chemotherapy, preparative regimen and maintenace therapy to improve the results of DLBCL patients , refractory even to AHSCT.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous hematopoietic stem cell transplantation, DLBCL