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High-dose Chemotherapy Combined with Autologous Hematopoietic Stem Cell Transplantation as Frontline Therapy for Intermediate/High-risk Diffuse Large B Cell Lymphoma

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Summary

The role of autologous hematopoietic stem cell transplantation (auto-HSCT) following high-dose chemotherapy has been validated and accepted as a standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL). However, its clinical efficacy as frontline therapy remains to be elucidated. This study aimed to examine the feasibility of frontline auto-HSCT for newly diagnosed intermediate/high-risk DLBCL patients. We retrospectively reviewed the data of 223 patients treated with frontline auto-HSCT or chemotherapy alone (year 2008–2014) from four hospitals. The median follow-up time was 29.4 months. Between the two treatment arms among the intermediate/high-risk DLBCL patients, the 3-year overall survival (OS) and progression-free survival (PFS) rates of patients given frontline auto-HSCT were 87.6% and 81.9%, respectively, and the chemotherapy-alone group showed 3-year OS and PFS rates of 64.9% and 59.59%, respectively. Compared with the chemotherapy-alone group, the frontline auto-HSCT could eliminate the adverse impact of non-germinal center B-cell (GCB) type. In addition, in the frontline auto-HSCT group, patients who achieved complete response (CR) at auto-HSCT had a longer survival time than those who did not achieve CR. Our results suggested that frontline auto-HSCT could improve the prognosis of intermediate/high-risk DLBCL patients.

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Authors and Affiliations

  1. Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China

    Qin Wen, Li Gao, Jing-kang Xiong, Qiong Li, Cheng Zhang, Yao Liu, Pei-yan Kong, Xian-gui Peng, Jun Rao, Lei Gao & Xi Zhang

  2. Department of Hematology, General Hospital of Kunming Military Region of PLA, Kunming, 650032, China

    San-bin Wang

  3. Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China

    Ji-shi Wang

  4. Department of Hematology, General Hospital of Chengdu Military Region of People’s Liberation Army, Chengdu, 610000, China

    Fang Liu

  5. State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, 400037, China

    Qin Wen, Li Gao, Jing-kang Xiong, Qiong Li, Cheng Zhang, Yao Liu, Pei-yan Kong, Xian-gui Peng, Jun Rao, Lei Gao & Xi Zhang

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  1. Qin Wen
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Correspondence to Jun Rao or Lei Gao.

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Additional information

This study was supported by the National Natural Science Foundation of China (No. 82070208), the Technique Innovation and Applied Program of Chongqing (No. cstc2019jscx-msxmX0187), the Natural Science Key Foundation of Chongqing (No. cstc2019jcyj-zdxmX0023), the Science and Technology Innovation Promotion Project of Army Medical University (No. 2019XLC3020), the Translational Research Program of National Clinical Research Center for Hematologic Diseases (Nos. 2020ZKZC02, 2021WWB05).

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Wen, Q., Gao, L., Xiong, Jk. et al. High-dose Chemotherapy Combined with Autologous Hematopoietic Stem Cell Transplantation as Frontline Therapy for Intermediate/High-risk Diffuse Large B Cell Lymphoma. CURR MED SCI 41, 465–473 (2021). https://doi.org/10.1007/s11596-021-2394-2

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