[Autologous hematopoietic stem cell transplantation for the treatment of aggressive non-Hodgkin's lymphoma. The experience of Polish lymphoma research group].

Abstract

We analysed the outcome of 200 patients, aged 38 (13-72) years, with aggressive non-Hodgkin's lymphoma (NHL) treated with high-dose chemotherapy followed by autologous haematopoietic stem cell transplantation (autoHSCT) in ten oncohaematological centres belonging to Polish Lymphoma Research Group (PLRG). The source of stem cells for transplantation was peripheral blood (autoPBSCT, n = 153), bone marrow (autoBMT, n = 40) or both blood and bone marrow (n = 7). The probability of overall survival (OS) and progression-free survival at 10 years was 51% (+/- 7%). The transplant-related mortality rate equalled 7%. In multivariate analysis, the only factor influencing independently the probability of OS was disease status at transplantation (p < 0.00001). The outcome of patients transplanted in first or subsequent complete remission or first partial remission (PR) was significantly better compared with subjects given autoHSCT in PR 2 or those with primary or secondary refractoriness. Regarding histological subtypes, the highest OS rate (87%) was observed for anaplastic large T cell lymphoma. The outcome after autoBMT was better compared with autoPBSCT (OS probability: 67% vs. 43%), although the difference did not reach statistical significance. We conclude that high-dose therapy followed by autoHSCT is an effective option for high-risk aggressive NHL. Remission status is a major factor determining long-term outcome. This should be taken into account when referring patients for autoHSCT.

• Authors: Jerzy Hołowiecki, Sebastian Giebel, Jan Walewski, Małgorzata Krawczyk-Kuliś, Andrzej Hellmann, Aleksander Skotnicki, Anna Dmoszyńska, Joanna Romejko, Jarosław Czyz, Wojciech Jurczak, Łucja Kachel, Jerzy Wojnar, Beata Stella-Hołowiecka, Maria Saduś-Wojciechowska, Kazimierz Sułek, Wiesław Jedrzejczak, Tadeusz Robak, Bozena Mariańska, Cezary Szczylik, Krzysztof Warzocha
• Journal: Polskie Archiwum Medycyny Wewnetrznej (Pol Arch Med Wewn) Vol. 110 Issue 2 Pg. 863-8 (Aug 2003) Poland
• Vernacular Title: Autologiczna transplantacja komórek hematopoetycznych w leczeniu agresywnych chłoniaków nieziarniczych Doświadczenie Polskiej Grupy Badawczej Chłoniaków (PLRG).
• PMID: 14682225 (Publication Type: Clinical Trial, English Abstract, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Child
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Lymphoma, Non-Hodgkin (pathology, surgery)
• Male
• Middle Aged
• Neoplasm Staging
• Transplantation, Autologous