Time of relapse after initial therapy significantly adds to the prognostic value of the IPI-R in patients with relapsed DLBCL undergoing autologous stem cell transplantation

Bone Marrow Transplantation
Luciano J CostaStephen M Ansell

Abstract

We explored the concomitant effect of the International Prognostic Index at the time of relapse (IPI-R) and the time from initial diagnosis to relapse (TTR) on outcome of 80 uniformly treated patients receiving BEAM conditioning followed by SCT for relapsed, chemosensitive diffuse large B-cell lymphoma. Median age at the time of transplantation was 62 years (range 26-77). Median follow-up of survivors was 31.4 months. Median overall survival (OS) from the time of transplant for patients with TTR >18 months vs < or =18 months was not reached and 50 months, respectively (P=0.01). Median OS for patients with IPI-R > or =3 was 23.3 months and not reached for patients with IPI-R <3 (P=0.01). These factors were independent in multivariate analysis with relative risk for death of 0.91 (0.80-0.99; P=0.04) for each 6-month increment in TTR and 0.63 (0.42-0.96; P=0.03) for IPI-R <3. TTR < or =18 months and IPI-R > or =3 were combined in a prognostic system where patients with none (n=32), one (n=39) or two (n=9) of these factors had median OS not reached, of 50 and 5 months, respectively (P<0.01). Patients with early, high IPI-R relapse after first-line therapy have a dismal outcome with SCT and should receive experimental therapies.

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Citations

Aug 19, 2008·Current Oncology Reports·Vaishalee Padgaonkar Kenkre, Sonali M Smith
Mar 8, 2008·American Journal of Respiratory Cell and Molecular Biology·Carlos H SerezaniMarc Peters-Golden
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Jul 3, 2019·Asia-Pacific Journal of Clinical Oncology·Shiyu JiangYuankai Shi
Nov 5, 2021·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Bernd MetznerClaus Henning Köhne

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