1. Autologous stem cell transplantation (ASCT) in patients with mantle cell lymphoma: a retrospective study of the Spanish lymphoma group (GELTAMO).
- Author
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García-Noblejas A, Cannata-Ortiz J, Conde E, González Barca E, Gutiérrez N, Rojas R, Vidal MJ, Ramírez MJ, Jiménez-Ubieto A, García-Ruiz JC, Sancho JM, López A, Ríos Rull P, Novelli S, Albo C, Debén G, López-Guillermo A, Nicolás C, González de Villambrosia S, Mercadal S, Martín García-Sancho A, and Arranz R
- Subjects
- Adult, Aged, Cytarabine administration & dosage, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Outcome Assessment, Health Care methods, Outcome Assessment, Health Care statistics & numerical data, Proportional Hazards Models, Remission Induction, Retrospective Studies, Rituximab administration & dosage, Transplantation Conditioning, Transplantation, Autologous, Young Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation methods, Lymphoma, Mantle-Cell therapy
- Abstract
Guidelines recommend autologous stem cell transplantation (ASCT) consolidation in first complete or partial response after regimens including rituximab (R) and high-dose AraC (HDAC), but its use beyond that response is questioned. We present a retrospective analysis of 268 patients with MCL who received ASCT. With a median follow-up for survival patients of 54 months, progression-free survival and overall survival for the whole series were 38 and 74 months, respectively, and for patients transplanted in first CR 49 and 97 months, respectively. Patients without CR before transplant were analyzed separately, those who achieved CR after transplantation had better PFS (48 vs 0.03 months, p < 0.001) and OS (92 vs 16 months, p < 0.001) than the remaining. In univariate analysis, first CR at transplant (p = 0.01) and prior rituximab (p = 0.02) were the variables associated with PFS. For OS, the same variables resulted significant (p = 0.03 and p < 0.001, respectively). In multivariate analysis, only the status at transplant (first CR) remained significant. This retrospective study concludes that ASCT consolidation in first CR induces high survival rates. In other stages of disease, the need of ASCT as consolidation may be questioned.
- Published
- 2017
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