The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma

Craig Moskowitz, Stephen D Nimer, J. R. Glassman, C. S. Portlock, J. Yahalom, D. J. Straus, J. P. O'Brien, N. Elkin, J. R. Bertino, A. D. Zelenetz

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

We analyzed a group of 51 patients with primary refractory and relapsed intermediate-grade lymphoma (IGL) from the time of initiation of three cycles of second-line chemotherapy, ifosfamide, carboplatin and etoposide (ICE), in whom the intent was to administer curative high-dose chemoradiotherapy and autologous stem cell transplantation (ASCT). We sought to determine if the International Prognostic Index (IPI) assessed immediately prior to ICE, second-line IPI (sIPI), was predictive of outcome. The response rate to ICE-based chemotherapy was 69%, and 47% of the transplanted patients remain failure-free at 2.5 years. Stratification of patients based upon the sIPI demonstrated a superior 2.5 year failure-free survival (FFS) curve for patients with low (I) or low-intermediate (II) risk disease vs those with high-intermediate (III) and high (IV) risk disease (45% vs 9%, P < 0.001). When the analysis was restricted to those patients with chemosensitive disease, the sIPI (I/II vs III/IV) also separated patients into two distinct prognostic groups (59% vs 20%, P = 0.04). Patients with sIPI I and II disease have a favorable outcome with ICE chemotherapy and ASCT. However, patients with sIPI III and IV disease derive limited benefit from this treatment strategy, and new approaches are needed in this patient group.

Original languageEnglish
Pages (from-to)561-567
Number of pages7
JournalBone Marrow Transplantation
Volume23
Issue number6
StatePublished - Mar 30 1999
Externally publishedYes

Fingerprint

Stem Cell Transplantation
Non-Hodgkin's Lymphoma
Ifosfamide
Carboplatin
Etoposide
Drug Therapy
Chemoradiotherapy
Survival

Keywords

  • ASCT
  • Intermediate-grade lymphoma
  • International Prognostic Index

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma. / Moskowitz, Craig; Nimer, Stephen D; Glassman, J. R.; Portlock, C. S.; Yahalom, J.; Straus, D. J.; O'Brien, J. P.; Elkin, N.; Bertino, J. R.; Zelenetz, A. D.

In: Bone Marrow Transplantation, Vol. 23, No. 6, 30.03.1999, p. 561-567.

Research output: Contribution to journalArticle

Moskowitz, Craig ; Nimer, Stephen D ; Glassman, J. R. ; Portlock, C. S. ; Yahalom, J. ; Straus, D. J. ; O'Brien, J. P. ; Elkin, N. ; Bertino, J. R. ; Zelenetz, A. D. / The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma. In: Bone Marrow Transplantation. 1999 ; Vol. 23, No. 6. pp. 561-567.
@article{d02177bded8a44489c4207ef9029eb42,
title = "The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma",
abstract = "We analyzed a group of 51 patients with primary refractory and relapsed intermediate-grade lymphoma (IGL) from the time of initiation of three cycles of second-line chemotherapy, ifosfamide, carboplatin and etoposide (ICE), in whom the intent was to administer curative high-dose chemoradiotherapy and autologous stem cell transplantation (ASCT). We sought to determine if the International Prognostic Index (IPI) assessed immediately prior to ICE, second-line IPI (sIPI), was predictive of outcome. The response rate to ICE-based chemotherapy was 69{\%}, and 47{\%} of the transplanted patients remain failure-free at 2.5 years. Stratification of patients based upon the sIPI demonstrated a superior 2.5 year failure-free survival (FFS) curve for patients with low (I) or low-intermediate (II) risk disease vs those with high-intermediate (III) and high (IV) risk disease (45{\%} vs 9{\%}, P < 0.001). When the analysis was restricted to those patients with chemosensitive disease, the sIPI (I/II vs III/IV) also separated patients into two distinct prognostic groups (59{\%} vs 20{\%}, P = 0.04). Patients with sIPI I and II disease have a favorable outcome with ICE chemotherapy and ASCT. However, patients with sIPI III and IV disease derive limited benefit from this treatment strategy, and new approaches are needed in this patient group.",
keywords = "ASCT, Intermediate-grade lymphoma, International Prognostic Index",
author = "Craig Moskowitz and Nimer, {Stephen D} and Glassman, {J. R.} and Portlock, {C. S.} and J. Yahalom and Straus, {D. J.} and O'Brien, {J. P.} and N. Elkin and Bertino, {J. R.} and Zelenetz, {A. D.}",
year = "1999",
month = "3",
day = "30",
language = "English",
volume = "23",
pages = "561--567",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma

AU - Moskowitz, Craig

AU - Nimer, Stephen D

AU - Glassman, J. R.

AU - Portlock, C. S.

AU - Yahalom, J.

AU - Straus, D. J.

AU - O'Brien, J. P.

AU - Elkin, N.

AU - Bertino, J. R.

AU - Zelenetz, A. D.

PY - 1999/3/30

Y1 - 1999/3/30

N2 - We analyzed a group of 51 patients with primary refractory and relapsed intermediate-grade lymphoma (IGL) from the time of initiation of three cycles of second-line chemotherapy, ifosfamide, carboplatin and etoposide (ICE), in whom the intent was to administer curative high-dose chemoradiotherapy and autologous stem cell transplantation (ASCT). We sought to determine if the International Prognostic Index (IPI) assessed immediately prior to ICE, second-line IPI (sIPI), was predictive of outcome. The response rate to ICE-based chemotherapy was 69%, and 47% of the transplanted patients remain failure-free at 2.5 years. Stratification of patients based upon the sIPI demonstrated a superior 2.5 year failure-free survival (FFS) curve for patients with low (I) or low-intermediate (II) risk disease vs those with high-intermediate (III) and high (IV) risk disease (45% vs 9%, P < 0.001). When the analysis was restricted to those patients with chemosensitive disease, the sIPI (I/II vs III/IV) also separated patients into two distinct prognostic groups (59% vs 20%, P = 0.04). Patients with sIPI I and II disease have a favorable outcome with ICE chemotherapy and ASCT. However, patients with sIPI III and IV disease derive limited benefit from this treatment strategy, and new approaches are needed in this patient group.

AB - We analyzed a group of 51 patients with primary refractory and relapsed intermediate-grade lymphoma (IGL) from the time of initiation of three cycles of second-line chemotherapy, ifosfamide, carboplatin and etoposide (ICE), in whom the intent was to administer curative high-dose chemoradiotherapy and autologous stem cell transplantation (ASCT). We sought to determine if the International Prognostic Index (IPI) assessed immediately prior to ICE, second-line IPI (sIPI), was predictive of outcome. The response rate to ICE-based chemotherapy was 69%, and 47% of the transplanted patients remain failure-free at 2.5 years. Stratification of patients based upon the sIPI demonstrated a superior 2.5 year failure-free survival (FFS) curve for patients with low (I) or low-intermediate (II) risk disease vs those with high-intermediate (III) and high (IV) risk disease (45% vs 9%, P < 0.001). When the analysis was restricted to those patients with chemosensitive disease, the sIPI (I/II vs III/IV) also separated patients into two distinct prognostic groups (59% vs 20%, P = 0.04). Patients with sIPI I and II disease have a favorable outcome with ICE chemotherapy and ASCT. However, patients with sIPI III and IV disease derive limited benefit from this treatment strategy, and new approaches are needed in this patient group.

KW - ASCT

KW - Intermediate-grade lymphoma

KW - International Prognostic Index

UR - http://www.scopus.com/inward/record.url?scp=0032984816&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032984816&partnerID=8YFLogxK

M3 - Article

C2 - 10217186

AN - SCOPUS:0032984816

VL - 23

SP - 561

EP - 567

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 6

ER -