High-dose therapy and autologous stem-cell support for chemosensitive transformed low-grade follicular non-Hodgkin's lymphoma: A case-matched study from the European bone marrow transplant registry
Cd. Williams et al., High-dose therapy and autologous stem-cell support for chemosensitive transformed low-grade follicular non-Hodgkin's lymphoma: A case-matched study from the European bone marrow transplant registry, J CL ONCOL, 19(3), 2001, pp. 727-735
Purpose: To assess the outcome of high-dose therapy with autologous stem-ce
ll support in patients with histologic transformation of low-grade follicul
ar non-Hodgkin's lymphoma (NHL) and identify significant prognostic factors
, as well as to compare survival of these patients with that of patients wi
th matched low-grade and de novo high- or intermediate-grade NHL undergoing
the same procedure.
Patients and Methods: Fifty patients with transformed low-grade NHL have be
en reported to the European Bone Marrow Transplant registry. Outcome from h
igh-dose therapy and significant prognostic factors were analyzed, Their su
rvival was also compared with that of 200 patients with matched low-grade N
HL and 200 patients with matched de novo high- or intermediate-grade NHL by
a case-matched analysis.
Results: The procedure-related death rate among the 50 transformed NHL pati
ents was 18%. Overall survival (OS) and progression-free survival (PFS) rat
es were 51% and 30% at 5 years, respectively. Median PFS time was 13 months
. Raised lactate dehydrogenase levels at transformation (P = .0031) was ide
ntified as the only adverse significant predictor of PFS on multivariate an
alysis. A subgroup of patients with residual chemosensitive disease who att
ained complete remission after high-dose therapy had the best outcome, with
an OS at 5 years of 69%. A comparison with matched patients with low-grade
disease and with de novo high- or intermediate-grade lymphoma showed no si
gnificant difference in OS (P = .939 and P = .438, respectively).
Conclusion: Patients with chemosensitive transformed lymphoma should be ser
iously considered for high-dose therapy and autologous stem-cell support. (
C) 2001 by American Society of Clinical Oncology.