Role of high-dose therapy and initial response in survival of poor-risk patients with aggressive non-Hodgkin's lymphoma: a retrospective series on 126 patients from a single center

It is now established that a subgroup of non-Hodgkin's lymphoma (NHL) patie nts probably benefit from high-dose therapy (HDT), We therefore retrospecti vely analyzed survival of 126 consecutive patients with large cell lymphoma (LCL) and high-intermediate (HI) or highrisk (H) age-adjusted internationa l prognostic index (Aa-IPI), They received either standard chemotherapy (CT ) (66 patients), or HDT (60 patients). Distribution of the Aa-IPI scores sh owed no statistical significant difference between the two treatment groups . Complete response (CR) rate was 51% for the whole series, with 41% and 62 % for the standard CT group and HDT group, respectively, With a median foll ow-up of 63 months (range, 16 to 159), the 5-year overall survival (OS) and event-free survival (EFS) for all patients was 52% and 43%, respectively. There was a statistical significant difference in terms of survival towards the HDT group: OS at 76% vs 31%, EFS at 64% vs 24%. Patients who achieved CR with front-line therapy had a 5-year OS at 70%, while it was 34% for pat ients who were not in CR. These results are comparable to those reported in the literature, and strongly suggest that both initial CR achievement and HDT as front-line treatment are predictive factors for prolonged survival o f patients with poor-risk LCL.