Outcome after high‐dose chemotherapy and autologous stem cell transplantation in patients with aggressive B‐cell non‐Hodgkin's lymphoma

摘要

Abstract Objective For more than two decades, high‐dose chemotherapy ( HDT ) and autologous blood stem cell transplantation ( ABSCT ) were treatment options for patients with aggressive B‐cell non‐Hodgkin's lymphoma (B‐ NHL ). However, the ideal timing and the collective patient benefits are still being debated. Method We retrospectively analyzed the data of 163 patients with B‐ NHL who received an HDT protocol followed by ABSCT between 2001 and 2007. Patients were analyzed according to the time point of HDT / ABSCT to compare upfront (directly after induction, n?=?72, 44%) versus secondary transplantation (at first relapse, n?=?91, 56%). Results The overall response rate was 100% and 94% after upfront and secondary HDT / ABSCT , respectively. No significant differences were found for hematopoietic recovery and toxicity profile. The progression‐free survival ( PFS ) and overall survival ( OS ) probability were found to be significantly higher in the upfront HDT / ABSCT treatment group ( P? = ? .018 and P? = ? .004). In multivariate analysis, upfront HDT / ABSCT and low IPI risk score had a significant beneficial effect on OS ( P? = ? .031 and P? = ? .019). Conclusion HDT and ABSCT directly after induction chemotherapy were confirmed to be feasible with high PFS and OS rates. In addition, for patients with relapse after first‐line therapy and consecutively poor prognosis, HDT / ABSCT also offers an effective treatment strategy.