Quantifying Benefit of Autologous Transplantation for Relapsed Follicular Lymphoma Patients via Instrumental Variable Analysis

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Danielle H OhDouglas A Stewart

Abstract

The role of autologous stem cell transplantation (ASCT) in patients with relapsed follicular lymphoma (FL) remains controversial because of a lack of proven overall survival (OS) benefit versus nontransplant strategies. We conducted a comparative effectiveness research study involving 3 tertiary Canadian cancer centers to determine whether the ASCT-based approach used at 1 center improved OS relative to non-ASCT approaches used at the other centers. Of 1082 consecutive patients aged 18 to 60 years and diagnosed with FL from 2001 to 2010, the study population included 355 patients who experienced relapse from chemotherapy (center A = 96, center B = 84, center C = 175). Data were analyzed according to the instrumental variable of treatment center to control for confounding factors. The frequency of using ASCT at first or second relapse was significantly different between the centers (A = 58%, B = 7%, C = 5%, P < .001). With a median follow-up of 69.1 months, the actuarial 5-year OS rates after first chemotherapy relapse were 89%, 60%, and 60% for centers A, B, and C respectively (log rank P < .0001). Based on instrumental variable analysis, the use of ASCT at relapse 1 or 2 significantly decreased the risk of death from first rel...Continue Reading

References

Oct 1, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Harry C SchoutenGunnar Kvalheim
Sep 10, 2005·Blood·Lindsay M MortonMartha S Linet
May 23, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ama Z S RohatinerArnold S Freedman
Jan 15, 2008·Journal of Health Economics·Joseph V TerzaPaul J Rathouz
Jul 30, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Robert MarcusGeorge Stein
Dec 14, 2011·Leukemia & Lymphoma·Armando López-GuillermoUNKNOWN Spanish Lymphomas/Autologous Bone Marrow Transplant Group
Dec 23, 2011·Journal of the National Cancer Institute·Murtadha Al KhaboriMichael Crump
Oct 17, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Dawn L Hershman, Jason D Wright
Jan 23, 2013·American Journal of Hematology·Pier Luigi ZinzaniUNKNOWN Expert Panel of the Italian Society of Hematology
Feb 9, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B MetznerC H Köhne
Feb 13, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Diego VillaJohn Kuruvilla
Jun 28, 2013·Annals of the American Thoracic Society·Theodore J Iwashyna, Edward H Kennedy
Mar 7, 2014·Statistics in Medicine·Michael BaiocchiDylan S Small
Apr 2, 2014·American Journal of Hematology·Arnold Freedman
Aug 15, 2014·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M DreylingUNKNOWN ESMO Guidelines Working Group
Dec 17, 2014·Blood·Carla CasuloJonathan W Friedberg
Jul 1, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Carla CasuloJonathan W Friedberg

❮ Previous
Next ❯

Related Concepts

Related Feeds

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.