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Impact of high-dose chemotherapy and autologous transplantation as first-line therapy on the survival of high-risk diffuse large B cell lymphoma patients: a single-center study in Japan

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Abstract

High-dose chemotherapy (HDT), together with autologous stem cell transplantation (ASCT), plays an important role in the treatment of diffuse large B cell lymphoma (DLBCL), especially as second-line therapy. However, its significance in up-front settings remains to be elucidated. In our institute, patients with DLBCL in both the high-intermediate and high international prognostic index (IPI) groups initially underwent CHOP/R-CHOP treatment followed by HDT/ASCT at upfront settings between 2002 and 2011. We retrospectively analyzed 25 patients who were all treated with upfront HDT/ASCT. We excluded one patient who failed to undergo transplantation because of primary refractory disease from the analysis. The median follow-up was 77 months (range 17–110 months). Five-year overall survival (OS) and progression-free survival (PFS) were 91.7 and 79.2 %, respectively, which were higher than the equivalents in previous studies. The OS and PFS in the high-risk group were lower than those in the high-intermediate group. Treatment-related mortalities or fatal complication were not observed. Our results confirm that HDT/ASCT for high-risk aggressive lymphoma is a feasible and promising therapy, but patients with high IPI continued to have poor prognoses; improvements in treatment strategy are clearly needed. Since HDT/ASCT is an aggressive treatment option associated with long-term complications, we need to identify patient groups that will gain the maximum benefit from HDT/ASCT in the upfront setting.

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Authors and Affiliations

  1. Department of Hematology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, Japan

    Shojiro Inano, Makoto Iwasaki, Yoshihiro Iwamoto, Yuki Sueki, Akiko Fukunaga, Soshi Yanagita & Nobuyoshi Arima

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  1. Shojiro Inano
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  2. Makoto Iwasaki
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  3. Yoshihiro Iwamoto
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  4. Yuki Sueki
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  5. Akiko Fukunaga
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  6. Soshi Yanagita
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  7. Nobuyoshi Arima
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Correspondence to Shojiro Inano.

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Inano, S., Iwasaki, M., Iwamoto, Y. et al. Impact of high-dose chemotherapy and autologous transplantation as first-line therapy on the survival of high-risk diffuse large B cell lymphoma patients: a single-center study in Japan. Int J Hematol 99, 162–168 (2014). https://doi.org/10.1007/s12185-013-1486-6

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  • DOI: https://doi.org/10.1007/s12185-013-1486-6

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