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Annals of Hematology

, Volume 95, Issue 9, pp 1491–1501 | Cite as

The different roles of molecular classification according to upfront autologous stem cell transplantation in advanced-stage diffuse large B cell lymphoma patients with elevated serum lactate dehydrogenase

  • Yu Ri Kim
  • Soo-Jeong Kim
  • June-Won Cheong
  • Deok-Hwan Yang
  • Hyewon Lee
  • Hyeon-Seok Eom
  • Yong Oh Sung
  • Hyo Jung Kim
  • Hye Jin Kang
  • Won-Sik Lee
  • Yong Park
  • Woo-Ick Yang
  • Yoo Hong Min
  • Jin Seok KimEmail author
Original Article

Abstract

The non-germinal center B cell (non-GCB) subtype of diffuse large B cell lymphoma (DLBCL) is more related to poor prognosis than the GCB subtype. To investigate the role of molecular classification according to upfront autologous hematopoietic stem cell transplantation (ASCT), we retrospectively evaluated 219 newly diagnosed high-risk DLBCL patients. Eighty-one patients were in the ASCT group, and 138 patients were in the non-ASCT group. The ASCT group yielded significantly better overall survival (OS) and progression-free survival (PFS) than the non-ASCT group (p = 0.038 and p = 0.007), and patients with the non-GCB subtype were more related to inferior PFS than those with the GCB subtype (p = 0.020). After performing age-matching by using propensity scores, upfront ASCT continued to show better OS and PFS than non-ASCT (p = 0.046 and p = 0.026). In the non-ASCT group, the non-GCB subtype showed worse OS and PFS than the GCB subtype (p = 0.039 and p = 0.007). Patients who achieved complete response showed differences in OS and PFS according to molecular subtype (p = 0.007 and p = 0.002). In the ASCT group, there were no significant differences in OS and PFS according to molecular classification (p = 0.277 and p = 0.892). In conclusion, non-GCB subtype DLBCL patients showed poor OS and PFS in the non-ASCT group while they did not show clinical significance in the ASCT group. This suggests the possibility that upfront ASCT may improve the poor prognosis of non-GCB subtype in high-risk DLBCL.

Keywords

Diffuse large B cell lymphoma Autologous hematopoietic stem cell transplantation Germinal center B cell Non-germinal center B cell Rituximab 

Notes

Acknowledgments

This study was presented in the form of poster presentation at the 56th annual meeting of the American Society of Hematology, San Francisco, CA, December 6–9, 2014. This work was supported by a faculty research grant from Yonsei University College of Medicine (6-2014-0096).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Yu Ri Kim
    • 1
  • Soo-Jeong Kim
    • 1
  • June-Won Cheong
    • 1
  • Deok-Hwan Yang
    • 2
  • Hyewon Lee
    • 3
  • Hyeon-Seok Eom
    • 3
  • Yong Oh Sung
    • 4
  • Hyo Jung Kim
    • 5
  • Hye Jin Kang
    • 6
  • Won-Sik Lee
    • 7
  • Yong Park
    • 8
  • Woo-Ick Yang
    • 9
  • Yoo Hong Min
    • 1
  • Jin Seok Kim
    • 1
    Email author
  1. 1.Division of Hematology, Department of Internal Medicine, Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  2. 2.Department of Hematology-OncologyChonnam National University Hwasun HospitalHwasunSouth Korea
  3. 3.Hematologic-Oncology Clinic, Center for Specific Organs CancerNational Cancer CenterGoyangSouth Korea
  4. 4.Department of Internal MedicineDong-A University College of MedicineBusanSouth Korea
  5. 5.Department of Internal Medicine, Division of Hematology-Oncology, College of Medicine, Hallym UniversityHallym University Sacred Heart HospitalAnyangSouth Korea
  6. 6.Department of Internal Medicine, Division of Hematology-Oncology, Korea Cancer Center HospitalKorea Institute of Radiological and Medical SciencesSeoulSouth Korea
  7. 7.Department of Internal Medicine, Division of Hematology-Oncology, Busan Paik HospitalInje University College of MedicineBusanSouth Korea
  8. 8.Department of Internal Medicine, Division of Hematology-OncologyKorea University College of MedicineSeoulSouth Korea
  9. 9.Department of PathologyYonsei University College of MedicineSeoulSouth Korea

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