Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma

Paul A. Hamlin, Andrew D. Zelenetz, Tarun Kewalramani, Jing Qin, Jaya M. Satagopan, David Verbel, Ariela Noy, Carol S. Portlock, David J. Straus, Joachim Yahalom, Stephen D Nimer, Craig Moskowitz

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

Second-line chemotherapy followed by high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) cures less than half of the patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Prognostic models capable of predicting outcome are essential. In 3 sequential clinical trials, conducted from January 1993 to August 2000, we treated 150 patients with relapsed or primary refractory DLBCL with ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by HDT/ASCT for patients with chemosensitive disease. We evaluated the age-adjusted International Prognostic Index at the initiation of second-line therapy (sAAIPI) as a predictor of progression-free survival (PFS) and overall survival (OS). At a median follow-up of 4 years, the PFS and OS are 28% and 34% by intention to treat and 39% and 45% for only those patients with chemosensitive disease. Three risk groups with different PFS and OS were identified by the sAAIPI: low risk (0 factors), 70% and 74%; intermediate risk (1 factor), 39% and 49%; and high risk (2 or 3 factors), 16% and 18% (P < .001 for both PFS and OS). The sAAIPI also predicts the PFS and OS for patients with ICE-chemosensitive disease: low risk, 69% and 83%; intermediate risk, 46% and 55%; and high risk, 25% and 26% (P < .001 PFS and OS). The sAAIPI predicts outcome for patients with relapsed or primary refractory DLBCL in both intent-to-treat and chemosensitive populations. This powerful prognostic instrument should be used to evaluate new treatment approaches and to compare results of different regimens.

Original languageEnglish
Pages (from-to)1989-1996
Number of pages8
JournalBlood
Volume102
Issue number6
DOIs
StatePublished - Sep 15 2003
Externally publishedYes

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Lymphoma, Large B-Cell, Diffuse
Stem Cell Transplantation
Stem cells
Refractory materials
Disease-Free Survival
Cells
Survival
Ifosfamide
Carboplatin
Etoposide
Chemotherapy
Drug Therapy
Therapeutics
Clinical Trials
Population

ASJC Scopus subject areas

  • Hematology

Cite this

Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma. / Hamlin, Paul A.; Zelenetz, Andrew D.; Kewalramani, Tarun; Qin, Jing; Satagopan, Jaya M.; Verbel, David; Noy, Ariela; Portlock, Carol S.; Straus, David J.; Yahalom, Joachim; Nimer, Stephen D; Moskowitz, Craig.

In: Blood, Vol. 102, No. 6, 15.09.2003, p. 1989-1996.

Research output: Contribution to journalArticle

Hamlin, Paul A. ; Zelenetz, Andrew D. ; Kewalramani, Tarun ; Qin, Jing ; Satagopan, Jaya M. ; Verbel, David ; Noy, Ariela ; Portlock, Carol S. ; Straus, David J. ; Yahalom, Joachim ; Nimer, Stephen D ; Moskowitz, Craig. / Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma. In: Blood. 2003 ; Vol. 102, No. 6. pp. 1989-1996.
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abstract = "Second-line chemotherapy followed by high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) cures less than half of the patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Prognostic models capable of predicting outcome are essential. In 3 sequential clinical trials, conducted from January 1993 to August 2000, we treated 150 patients with relapsed or primary refractory DLBCL with ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by HDT/ASCT for patients with chemosensitive disease. We evaluated the age-adjusted International Prognostic Index at the initiation of second-line therapy (sAAIPI) as a predictor of progression-free survival (PFS) and overall survival (OS). At a median follow-up of 4 years, the PFS and OS are 28{\%} and 34{\%} by intention to treat and 39{\%} and 45{\%} for only those patients with chemosensitive disease. Three risk groups with different PFS and OS were identified by the sAAIPI: low risk (0 factors), 70{\%} and 74{\%}; intermediate risk (1 factor), 39{\%} and 49{\%}; and high risk (2 or 3 factors), 16{\%} and 18{\%} (P < .001 for both PFS and OS). The sAAIPI also predicts the PFS and OS for patients with ICE-chemosensitive disease: low risk, 69{\%} and 83{\%}; intermediate risk, 46{\%} and 55{\%}; and high risk, 25{\%} and 26{\%} (P < .001 PFS and OS). The sAAIPI predicts outcome for patients with relapsed or primary refractory DLBCL in both intent-to-treat and chemosensitive populations. This powerful prognostic instrument should be used to evaluate new treatment approaches and to compare results of different regimens.",
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T1 - Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma

AU - Hamlin, Paul A.

AU - Zelenetz, Andrew D.

AU - Kewalramani, Tarun

AU - Qin, Jing

AU - Satagopan, Jaya M.

AU - Verbel, David

AU - Noy, Ariela

AU - Portlock, Carol S.

AU - Straus, David J.

AU - Yahalom, Joachim

AU - Nimer, Stephen D

AU - Moskowitz, Craig

PY - 2003/9/15

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N2 - Second-line chemotherapy followed by high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) cures less than half of the patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Prognostic models capable of predicting outcome are essential. In 3 sequential clinical trials, conducted from January 1993 to August 2000, we treated 150 patients with relapsed or primary refractory DLBCL with ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by HDT/ASCT for patients with chemosensitive disease. We evaluated the age-adjusted International Prognostic Index at the initiation of second-line therapy (sAAIPI) as a predictor of progression-free survival (PFS) and overall survival (OS). At a median follow-up of 4 years, the PFS and OS are 28% and 34% by intention to treat and 39% and 45% for only those patients with chemosensitive disease. Three risk groups with different PFS and OS were identified by the sAAIPI: low risk (0 factors), 70% and 74%; intermediate risk (1 factor), 39% and 49%; and high risk (2 or 3 factors), 16% and 18% (P < .001 for both PFS and OS). The sAAIPI also predicts the PFS and OS for patients with ICE-chemosensitive disease: low risk, 69% and 83%; intermediate risk, 46% and 55%; and high risk, 25% and 26% (P < .001 PFS and OS). The sAAIPI predicts outcome for patients with relapsed or primary refractory DLBCL in both intent-to-treat and chemosensitive populations. This powerful prognostic instrument should be used to evaluate new treatment approaches and to compare results of different regimens.

AB - Second-line chemotherapy followed by high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) cures less than half of the patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Prognostic models capable of predicting outcome are essential. In 3 sequential clinical trials, conducted from January 1993 to August 2000, we treated 150 patients with relapsed or primary refractory DLBCL with ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by HDT/ASCT for patients with chemosensitive disease. We evaluated the age-adjusted International Prognostic Index at the initiation of second-line therapy (sAAIPI) as a predictor of progression-free survival (PFS) and overall survival (OS). At a median follow-up of 4 years, the PFS and OS are 28% and 34% by intention to treat and 39% and 45% for only those patients with chemosensitive disease. Three risk groups with different PFS and OS were identified by the sAAIPI: low risk (0 factors), 70% and 74%; intermediate risk (1 factor), 39% and 49%; and high risk (2 or 3 factors), 16% and 18% (P < .001 for both PFS and OS). The sAAIPI also predicts the PFS and OS for patients with ICE-chemosensitive disease: low risk, 69% and 83%; intermediate risk, 46% and 55%; and high risk, 25% and 26% (P < .001 PFS and OS). The sAAIPI predicts outcome for patients with relapsed or primary refractory DLBCL in both intent-to-treat and chemosensitive populations. This powerful prognostic instrument should be used to evaluate new treatment approaches and to compare results of different regimens.

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