Outcome of patients with relapsed diffuse large B-cell lymphoma who fail second-line salvage regimens in the International CORAL study

E. Van Den Neste, N. Schmitz, N. Mounier, D. Gill, D. Linch, M. Trneny, N. Milpied, J. Radford, N. Ketterer, O. Shpilberg, U. Dührsen, D. Ma, J. Brière, C. Thieblemont, G. Salles, C. H. Moskowitz, B. Glass, C. Gisselbrecht

Research output: Contribution to journalArticle

66 Scopus citations

Abstract

Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard second-line treatment for relapsed and refractory diffuse large B-cell lymphoma (DLBCL). However, the strategy is less clear in patients who require third-line treatment. Updated outcomes of 203 patients who could not proceed to scheduled ASCT in the Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) are herein reviewed. In the intent-to-treat analysis, overall response rate to third-line chemotherapy was 39%, with 27% CR or CR unconfirmed, and 12% PR. Among the 203 patients, 64 (31.5%) were eventually transplanted (ASCT 56, allogeneic SCT 8). Median overall survival (OS) of the entire population was 4.4 months. OS was significantly improved in patients with lower tertiary International Prognostic Index (IPI), patients responding to third-line treatment and patients transplanted with a 1-year OS of 41.6% compared with 16.3% for the not transplanted (P<0.0001). In multivariate analysis, IPI at relapse (hazard ratio (HR) 2.409) and transplantation (HR 0.375) independently predicted OS. Third-line salvage chemotherapy can lead to response followed by transplantation and long-term survival in DLBCL patients. However, improvement of salvage efficacy is an urgent need with new drugs.

Original languageEnglish (US)
Pages (from-to)51-57
Number of pages7
JournalBone Marrow Transplantation
Volume51
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Van Den Neste, E., Schmitz, N., Mounier, N., Gill, D., Linch, D., Trneny, M., Milpied, N., Radford, J., Ketterer, N., Shpilberg, O., Dührsen, U., Ma, D., Brière, J., Thieblemont, C., Salles, G., Moskowitz, C. H., Glass, B., & Gisselbrecht, C. (2016). Outcome of patients with relapsed diffuse large B-cell lymphoma who fail second-line salvage regimens in the International CORAL study. Bone Marrow Transplantation, 51(1), 51-57. https://doi.org/10.1038/bmt.2015.213