Autologous transplantation for diffuse aggressive Non-Hodgkin lymphoma in first relapse or second remission

Julie M. Vose, Douglas J. Rizzo, Jing Tao-Wu, James O. Armitage, Asad Bashey, Linda J. Burns, Neal Paul Christiansen, Cesar O. Freytes, Robert Peter Gale, John Gibson, Sergio A. Giralt, Roger H. Herzig, Charles F. Lemaistre, Philip L. McCarthy, Stephen D. Nimer, Finn B. Petersen, David P. Schenkein, Peter H. Wiernik, Joseph M. Wiley, Fausto R. LoberizaHillard M. Lazarus, Koen van Biesen, Mary M. Horowitz

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

We evaluated the results of high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with diffuse aggressive non-Hodgkin lymphoma (NHL) in first relapse (Rel 1) or second complete remission (CR 2). Data were evaluated from the Autologous Blood and Marrow Transplant Registry on 429 patients with diffuse aggressive NHL who underwent transplantation in Rel 1 or CR 2. Transplantations were performed between 1989 and 1996 and were reported to the Autologous Blood and Marrow Transplant Registry by 93 centers in North and South America. The probability of 3-year survival was 44% (95% confidence interval [CI], 33%-55%). The probability at 3 years of progression-free survival was 31% (95% CI, 27%-36%). Patients who underwent transplantation in CR 2 had a 3-year probability of progression-free survival of 38% (95% CI, 30%-46%) compared with 28% (95% CI, 22%-33%) for those who were not in remission at the time of transplantation (P<.001). In multivariate analysis, chemotherapy resistance, increased lactic dehydrogenase at diagnosis, an interval of <12 months from diagnosis to relapse, age ≥40 years, and use of myeloid growth factors to accelerate posttransplantation bone marrow recovery were adverse predictors of survival. High-dose chemotherapy and autologous hematopoietic stem cell transplantation for patients with diffuse aggressive NHL in CR 2 or Rel 1 resulted in better outcome for patients with chemotherapy-sensitive disease, longer relapse-free intervals, and age <40 years. Exposure to myeloid growth factors to accelerate recovery for recipients of bone marrow grafts may increase the risk of disease progression or death.

Original languageEnglish (US)
Pages (from-to)116-127
Number of pages12
JournalBiology of Blood and Marrow Transplantation
Volume10
Issue number2
DOIs
StatePublished - Feb 1 2004
Externally publishedYes

Keywords

  • Hematopoietic stem cell transplantation
  • High-dose chemotherapy
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Transplantation

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    Vose, J. M., Rizzo, D. J., Tao-Wu, J., Armitage, J. O., Bashey, A., Burns, L. J., Christiansen, N. P., Freytes, C. O., Gale, R. P., Gibson, J., Giralt, S. A., Herzig, R. H., Lemaistre, C. F., McCarthy, P. L., Nimer, S. D., Petersen, F. B., Schenkein, D. P., Wiernik, P. H., Wiley, J. M., ... Horowitz, M. M. (2004). Autologous transplantation for diffuse aggressive Non-Hodgkin lymphoma in first relapse or second remission. Biology of Blood and Marrow Transplantation, 10(2), 116-127. https://doi.org/10.1016/j.bbmt.2003.09.015