Contributions
Abstract: PB2416
Type: Publication Only
Background
The role of upfront ASCT in patients with diffuse large B cell lymphoma is still controversial.
Aims
We evaluated the effectiveness and safety profiles of upfront ASCT with 194 patients of DLBCL.
Methods
Total 151 patients (77.80%) achieved complete remission after ASCT and overall response rate was 84.0%.
Results
Treatment related mortality was 3.6% and 66 patients (34.0%) had progression or relapse. The 5-year overall survival rates and progression free survival rates were 72.3% and 54.6%. There were no significant differences in OS (p=0.371) and PFS (p=0.572) between BCNU conditioning group (BEAM) and busulfan conditioning groups (BuCyE or BuMelE). Neutrophil engraftment was significantly faster in busulfan group than in BCNU group (p=0.011). But, the frequency of mucositis was higher in busulfan groups than in BCNU group (p=0.03). Among the busulfan group, BuMelE group showed lower recurrence rate and higher rate of achievement of CR after ASCT than BuCyE group. Multivariate analysis for OS showed that performance status ≥2 (p< .001), non-rituximab induction therapy (p=0.011) and BuCyE conditioning (p=0.016) were poor prognostic factors. In addition, PS ≥2 (p=0.018), non-rituximab induction therapy (p=0.003) and non-CR status before ASCT (p=0.029) were significantly associated with poor prognosis in PFS. The following factors; stage, bulky disease, high LDH, bone marrow involvement and high risk IPI did not affect survival significantly.
Conclusion
In conclusion, it is considered that upfront ASCT can overcome the poor prognosis of high risk DLBCL patients. And busulfan based conditioning, especially BuMelE, is an effective conditioning regimen, showing similar efficacy and safety profile as BEAM conditioning.
Session topic: 23. Stem cell transplantation - Clinical
Abstract: PB2416
Type: Publication Only
Background
The role of upfront ASCT in patients with diffuse large B cell lymphoma is still controversial.
Aims
We evaluated the effectiveness and safety profiles of upfront ASCT with 194 patients of DLBCL.
Methods
Total 151 patients (77.80%) achieved complete remission after ASCT and overall response rate was 84.0%.
Results
Treatment related mortality was 3.6% and 66 patients (34.0%) had progression or relapse. The 5-year overall survival rates and progression free survival rates were 72.3% and 54.6%. There were no significant differences in OS (p=0.371) and PFS (p=0.572) between BCNU conditioning group (BEAM) and busulfan conditioning groups (BuCyE or BuMelE). Neutrophil engraftment was significantly faster in busulfan group than in BCNU group (p=0.011). But, the frequency of mucositis was higher in busulfan groups than in BCNU group (p=0.03). Among the busulfan group, BuMelE group showed lower recurrence rate and higher rate of achievement of CR after ASCT than BuCyE group. Multivariate analysis for OS showed that performance status ≥2 (p< .001), non-rituximab induction therapy (p=0.011) and BuCyE conditioning (p=0.016) were poor prognostic factors. In addition, PS ≥2 (p=0.018), non-rituximab induction therapy (p=0.003) and non-CR status before ASCT (p=0.029) were significantly associated with poor prognosis in PFS. The following factors; stage, bulky disease, high LDH, bone marrow involvement and high risk IPI did not affect survival significantly.
Conclusion
In conclusion, it is considered that upfront ASCT can overcome the poor prognosis of high risk DLBCL patients. And busulfan based conditioning, especially BuMelE, is an effective conditioning regimen, showing similar efficacy and safety profile as BEAM conditioning.
Session topic: 23. Stem cell transplantation - Clinical