Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation

Man Hsin Hung; Yuan Bin Yu; Yu Chung Huang; Han Tsung Liu; Ying Chung Hong; Liang Tsai Hsiao; Jin Hwang Liu; Jyh Pyng Gau; Tzeon Jye Chiou; Po Min Chen; Cheng Hwai Tzeng; Chun Yu Liu

doi:10.1007/s00277-012-1536-9

Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation

Man Hsin Hung, Yuan Bin Yu, Yu Chung Huang, Han Tsung Liu, Ying Chung Hong, Liang Tsai Hsiao, Jin Hwang Liu, Jyh Pyng Gau, Tzeon Jye Chiou, Po Min Chen, Cheng Hwai Tzeng, Chun Yu Liu

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6 Citations (Scopus)

Abstract

Certain portions of patientswith diffuse large B cell lymphoma (DLBCL) do not achieve a complete remission after first-line rituximab combining chemotherapy. This retrospective study aimed to characterize the outcome of patients with DLBCL that achieved partial remission or had stable disease after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The effects of subsequent treatments and factors associated with eventfree survival (EFS) after second-line treatments were analyzed. A total of 103 patients were enrolled and 81 (76.8 %) patients received intensive chemotherapy, whereas the others (23.2 %) received either palliative chemotherapy or supportive care post first-line treatment. Patients receiving intensive chemotherapy had significantly higher EFS (median 7.9 months) than the others; 28 (34.6 %) patients in this group received autologous stem cell transplantation (ASCT), which may have further improved the EFS. An International Prognostic Index (IPI) >2 and absolute lymphocyte count (ALC) at diagnosis <1,000/UL were significant prognostic factors associated with worse EFS. The survival advantage of ASCT remained significant after adjustment for these factors. The results suggest intensive chemotherapy plus ASCT may provide modest disease control in patients with DLBCL who achieve PR or SD to first-line R-CHOP, particularly in those with a higher IPI score and/or low ALC at diagnosis.

Original language	English
Pages (from-to)	1907-1915
Number of pages	9
Journal	Annals of Hematology
Volume	91
Issue number	12
DOIs	https://doi.org/10.1007/s00277-012-1536-9
Publication status	Published - Dec 2012
Externally published	Yes

Keywords

Absolute lymphocyte count
Autologous stem cell transplantation
Incomplete response
Non-Hodgkin's lymphoma (NHL)
Rituximab

ASJC Scopus subject areas

Hematology

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Hung, M. H., Yu, Y. B., Huang, Y. C., Liu, H. T., Hong, Y. C., Hsiao, L. T., Liu, J. H., Gau, J. P., Chiou, T. J., Chen, P. M., Tzeng, C. H., & Liu, C. Y. (2012). Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation. Annals of Hematology, 91(12), 1907-1915. https://doi.org/10.1007/s00277-012-1536-9

Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation. / Hung, Man Hsin; Yu, Yuan Bin; Huang, Yu Chung et al.
In: Annals of Hematology, Vol. 91, No. 12, 12.2012, p. 1907-1915.

Research output: Contribution to journal › Article › peer-review

Hung, MH, Yu, YB, Huang, YC, Liu, HT, Hong, YC, Hsiao, LT, Liu, JH, Gau, JP, Chiou, TJ, Chen, PM, Tzeng, CH & Liu, CY 2012, 'Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation', Annals of Hematology, vol. 91, no. 12, pp. 1907-1915. https://doi.org/10.1007/s00277-012-1536-9

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title = "Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation",

abstract = "Certain portions of patientswith diffuse large B cell lymphoma (DLBCL) do not achieve a complete remission after first-line rituximab combining chemotherapy. This retrospective study aimed to characterize the outcome of patients with DLBCL that achieved partial remission or had stable disease after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The effects of subsequent treatments and factors associated with eventfree survival (EFS) after second-line treatments were analyzed. A total of 103 patients were enrolled and 81 (76.8 %) patients received intensive chemotherapy, whereas the others (23.2 %) received either palliative chemotherapy or supportive care post first-line treatment. Patients receiving intensive chemotherapy had significantly higher EFS (median 7.9 months) than the others; 28 (34.6 %) patients in this group received autologous stem cell transplantation (ASCT), which may have further improved the EFS. An International Prognostic Index (IPI) >2 and absolute lymphocyte count (ALC) at diagnosis <1,000/UL were significant prognostic factors associated with worse EFS. The survival advantage of ASCT remained significant after adjustment for these factors. The results suggest intensive chemotherapy plus ASCT may provide modest disease control in patients with DLBCL who achieve PR or SD to first-line R-CHOP, particularly in those with a higher IPI score and/or low ALC at diagnosis.",

keywords = "Absolute lymphocyte count, Autologous stem cell transplantation, Incomplete response, Non-Hodgkin's lymphoma (NHL), Rituximab",

author = "Hung, {Man Hsin} and Yu, {Yuan Bin} and Huang, {Yu Chung} and Liu, {Han Tsung} and Hong, {Ying Chung} and Hsiao, {Liang Tsai} and Liu, {Jin Hwang} and Gau, {Jyh Pyng} and Chiou, {Tzeon Jye} and Chen, {Po Min} and Tzeng, {Cheng Hwai} and Liu, {Chun Yu}",

note = "Funding Information: Acknowledgments This study was partially supported by a grant from the Taiwan Clinical Oncology Research Foundation and a grant from Taipei VGH (V101A-023). The authors thank Mrs. Ya-Wen Yang from the Division of Biostatistics, Institute of Public Health, National Yang Ming University, Taipei, Taiwan for her assistance in statistical analysis.",

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T1 - Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP

T2 - The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation

AU - Hung, Man Hsin

AU - Yu, Yuan Bin

AU - Huang, Yu Chung

AU - Liu, Han Tsung

AU - Hong, Ying Chung

AU - Hsiao, Liang Tsai

AU - Liu, Jin Hwang

AU - Gau, Jyh Pyng

AU - Chiou, Tzeon Jye

AU - Chen, Po Min

AU - Tzeng, Cheng Hwai

AU - Liu, Chun Yu

N1 - Funding Information: Acknowledgments This study was partially supported by a grant from the Taiwan Clinical Oncology Research Foundation and a grant from Taipei VGH (V101A-023). The authors thank Mrs. Ya-Wen Yang from the Division of Biostatistics, Institute of Public Health, National Yang Ming University, Taipei, Taiwan for her assistance in statistical analysis.

PY - 2012/12

Y1 - 2012/12

N2 - Certain portions of patientswith diffuse large B cell lymphoma (DLBCL) do not achieve a complete remission after first-line rituximab combining chemotherapy. This retrospective study aimed to characterize the outcome of patients with DLBCL that achieved partial remission or had stable disease after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The effects of subsequent treatments and factors associated with eventfree survival (EFS) after second-line treatments were analyzed. A total of 103 patients were enrolled and 81 (76.8 %) patients received intensive chemotherapy, whereas the others (23.2 %) received either palliative chemotherapy or supportive care post first-line treatment. Patients receiving intensive chemotherapy had significantly higher EFS (median 7.9 months) than the others; 28 (34.6 %) patients in this group received autologous stem cell transplantation (ASCT), which may have further improved the EFS. An International Prognostic Index (IPI) >2 and absolute lymphocyte count (ALC) at diagnosis <1,000/UL were significant prognostic factors associated with worse EFS. The survival advantage of ASCT remained significant after adjustment for these factors. The results suggest intensive chemotherapy plus ASCT may provide modest disease control in patients with DLBCL who achieve PR or SD to first-line R-CHOP, particularly in those with a higher IPI score and/or low ALC at diagnosis.

AB - Certain portions of patientswith diffuse large B cell lymphoma (DLBCL) do not achieve a complete remission after first-line rituximab combining chemotherapy. This retrospective study aimed to characterize the outcome of patients with DLBCL that achieved partial remission or had stable disease after first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The effects of subsequent treatments and factors associated with eventfree survival (EFS) after second-line treatments were analyzed. A total of 103 patients were enrolled and 81 (76.8 %) patients received intensive chemotherapy, whereas the others (23.2 %) received either palliative chemotherapy or supportive care post first-line treatment. Patients receiving intensive chemotherapy had significantly higher EFS (median 7.9 months) than the others; 28 (34.6 %) patients in this group received autologous stem cell transplantation (ASCT), which may have further improved the EFS. An International Prognostic Index (IPI) >2 and absolute lymphocyte count (ALC) at diagnosis <1,000/UL were significant prognostic factors associated with worse EFS. The survival advantage of ASCT remained significant after adjustment for these factors. The results suggest intensive chemotherapy plus ASCT may provide modest disease control in patients with DLBCL who achieve PR or SD to first-line R-CHOP, particularly in those with a higher IPI score and/or low ALC at diagnosis.

KW - Absolute lymphocyte count

KW - Autologous stem cell transplantation

KW - Incomplete response

KW - Non-Hodgkin's lymphoma (NHL)

KW - Rituximab

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Patients with diffuse large B cell lymphoma in partial response or stable disease after first-line R-CHOP: The prognostic value of the absolute lymphocyte count and impact of autologous stem cell transplantation

Abstract

Keywords

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