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Autologous transplant for relapsed follicular lymphoma: impact of pre-transplant rituximab sensitivity.
- Source :
-
Leukemia & lymphoma [Leuk Lymphoma] 2015 Jan; Vol. 56 (1), pp. 92-6. Date of Electronic Publication: 2014 Jun 17. - Publication Year :
- 2015
-
Abstract
- Patients with rituximab-refractory follicular lymphoma (FL) have limited options. Before the rituximab era, autologous stem cell transplant (ASCT) was shown to improve outcomes in chemotherapy-sensitive, relapsed FL, but the impact of rituximab-sensitivity on these results is unknown. We analyzed 194 consecutive relapsed patients with FL who underwent ASCT at out center and categorized them as rituximab-sensitive (RS, n = 35), rituximab-refractory (RR, n = 65) or no rituximab (NoR, n = 94) if transplanted before rituximab was used. Progression-free survival at 3 years was 85% in RS and 35% in RR patients (p = 0.0004). Only rituximab-sensitivity was significant on multivariate analysis with improved overall survival (OS) (hazard ratio [HR] 0.24, p = 0.01) and progression-free survival (PFS) (HR 0.35, p = 0.006) in RS patients and increased relapse in RR patients (HR 2.11, p = 0.01). Pre-transplant rituximab-sensitivity is a strong independent predictor of post-transplant outcomes in relapsed FL, although one-third of RR patients achieved a PFS of over 3 years with ASCT.
- Subjects :
- Adolescent
Adult
Aged
Antibodies, Monoclonal, Murine-Derived therapeutic use
Antineoplastic Agents therapeutic use
Autografts
Combined Modality Therapy
Drug Resistance, Neoplasm
Female
Humans
Lymphoma, Follicular mortality
Male
Middle Aged
Neoplasm Recurrence, Local
Retreatment
Retrospective Studies
Rituximab
Survival Analysis
Treatment Outcome
Young Adult
Hematopoietic Stem Cell Transplantation
Lymphoma, Follicular pathology
Lymphoma, Follicular therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1029-2403
- Volume :
- 56
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Leukemia & lymphoma
- Publication Type :
- Academic Journal
- Accession number :
- 24707941
- Full Text :
- https://doi.org/10.3109/10428194.2014.911866