Annals of Hematology

, Volume 91, Issue 12, pp 1907–1915

Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: the prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation

  • Man-Hsin Hung
  • Yuan-Bin Yu
  • Yu-Chung Huang
  • Han-Tsung Liu
  • Ying-Chung Hong
  • Liang-Tsai Hsiao
  • Jin-Hwang Liu
  • Jyh-Pyng Gau
  • Tzeon-Jye Chiou
  • Po-Min Chen
  • Cheng-Hwai Tzeng
  • Chun-Yu Liu
Original Article

Abstract

Certain portions of patients with diffuse large B cell lymphoma (DLBCL) do not achieve a complete remission after first-line rituximab combining chemotherapy. This retrospective study aimed to characterize the outcome of patients with DLBCL that achieved partial remission or had stable disease after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The effects of subsequent treatments and factors associated with event-free survival (EFS) after second-line treatments were analyzed. A total of 103 patients were enrolled and 81 (76.8 %) patients received intensive chemotherapy, whereas the others (23.2 %) received either palliative chemotherapy or supportive care post first-line treatment. Patients receiving intensive chemotherapy had significantly higher EFS (median 7.9 months) than the others; 28 (34.6 %) patients in this group received autologous stem cell transplantation (ASCT), which may have further improved the EFS. An International Prognostic Index (IPI) >2 and absolute lymphocyte count (ALC) at diagnosis <1,000/UL were significant prognostic factors associated with worse EFS. The survival advantage of ASCT remained significant after adjustment for these factors. The results suggest intensive chemotherapy plus ASCT may provide modest disease control in patients with DLBCL who achieve PR or SD to first-line R-CHOP, particularly in those with a higher IPI score and/or low ALC at diagnosis.

Keywords

Non-Hodgkin’s lymphoma (NHL) Rituximab Incomplete response Absolute lymphocyte count Autologous stem cell transplantation 

Supplementary material

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ESM 1(DOCX 12 kb)

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Man-Hsin Hung
    • 1
    • 3
  • Yuan-Bin Yu
    • 1
    • 3
  • Yu-Chung Huang
    • 1
    • 3
    • 5
    • 6
  • Han-Tsung Liu
    • 1
    • 3
    • 4
    • 7
  • Ying-Chung Hong
    • 1
    • 3
  • Liang-Tsai Hsiao
    • 1
    • 3
  • Jin-Hwang Liu
    • 1
    • 3
  • Jyh-Pyng Gau
    • 1
    • 3
  • Tzeon-Jye Chiou
    • 2
    • 3
  • Po-Min Chen
    • 1
    • 3
  • Cheng-Hwai Tzeng
    • 1
    • 3
  • Chun-Yu Liu
    • 1
    • 3
    • 4
  1. 1.Division of Haematology and Oncology, Department of MedicineTaipei Veterans General HospitalTaipeiRepublic of China
  2. 2.Division of Transfusion Medicine, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
  3. 3.National Yang-Ming University School of MedicineTaipeiTaiwan
  4. 4.Institute of Biopharmaceutical SciencesNational Yang-Ming UniversityTaipeiTaiwan
  5. 5.Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan
  6. 6.Division of Haematology and Oncology, Department of MedicineTaoyuan Veterans HospitalTaipeiTaiwan
  7. 7.Department of MedicineZhonghxiao Branch of Taipei City HospitalTaipeiTaiwan

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