Abstract
BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non-Hodgkin lymphoma (NHL) patients undergoing reduced-intensity allogeneic hematopoietic stem cell transplantation (allo-HCT). The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post-transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post-transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced-intensity allo-HCT. RESULTS: The 3-year event-free survival (EFS) and overall survival (OS) (median potential follow-up after reduced-intensity allo-HCT = 58 months) for all patients was 37% and 47%, respectively. The 3-year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3-year follow-up. The 3-year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3-year EFS based on post-transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post-transplant reached 3-year follow-up. The 3-year OS based on post-transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P < .0001). Pretransplant response (P < .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reducedintensity allo-HCT, and patients with pretransplant PD should only receive this therapy in clinical trials.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 852-862 |
| Number of pages | 11 |
| Journal | Cancer |
| Volume | 116 |
| Issue number | 4 |
| DOIs | |
| State | Published - Feb 15 2010 |
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Keywords
- Chemotherapy sensitivity
- Hematopoietic stem cell transplantation
- Non-Hodgkin lymphoma
- Nonmyeloablative
- Reduced-intensity
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Correlation of pretransplant and early post-transplant response assessment with outcomes after reduced-intensity allogeneic hematopoietic stem cell transplantation for non-Hodgkin's lymphoma. / Bishop, Michael R.; Dean, Robert M.; Steinberg, Seth M.; Odom, Jeanne; Pollack, Seth M.; Pavletic, Steven Z.; Sportes, Claude; Gress, Ronald E.; Fowler, Daniel H.
In: Cancer, Vol. 116, No. 4, 15.02.2010, p. 852-862.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Correlation of pretransplant and early post-transplant response assessment with outcomes after reduced-intensity allogeneic hematopoietic stem cell transplantation for non-Hodgkin's lymphoma
AU - Bishop, Michael R.
AU - Dean, Robert M.
AU - Steinberg, Seth M.
AU - Odom, Jeanne
AU - Pollack, Seth M.
AU - Pavletic, Steven Z.
AU - Sportes, Claude
AU - Gress, Ronald E.
AU - Fowler, Daniel H.
PY - 2010/2/15
Y1 - 2010/2/15
N2 - BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non-Hodgkin lymphoma (NHL) patients undergoing reduced-intensity allogeneic hematopoietic stem cell transplantation (allo-HCT). The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post-transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post-transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced-intensity allo-HCT. RESULTS: The 3-year event-free survival (EFS) and overall survival (OS) (median potential follow-up after reduced-intensity allo-HCT = 58 months) for all patients was 37% and 47%, respectively. The 3-year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3-year follow-up. The 3-year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3-year EFS based on post-transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post-transplant reached 3-year follow-up. The 3-year OS based on post-transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P < .0001). Pretransplant response (P < .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reducedintensity allo-HCT, and patients with pretransplant PD should only receive this therapy in clinical trials.
AB - BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non-Hodgkin lymphoma (NHL) patients undergoing reduced-intensity allogeneic hematopoietic stem cell transplantation (allo-HCT). The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post-transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post-transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced-intensity allo-HCT. RESULTS: The 3-year event-free survival (EFS) and overall survival (OS) (median potential follow-up after reduced-intensity allo-HCT = 58 months) for all patients was 37% and 47%, respectively. The 3-year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3-year follow-up. The 3-year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3-year EFS based on post-transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post-transplant reached 3-year follow-up. The 3-year OS based on post-transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P < .0001). Pretransplant response (P < .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reducedintensity allo-HCT, and patients with pretransplant PD should only receive this therapy in clinical trials.
KW - Chemotherapy sensitivity
KW - Hematopoietic stem cell transplantation
KW - Non-Hodgkin lymphoma
KW - Nonmyeloablative
KW - Reduced-intensity
UR - http://www.scopus.com/inward/record.url?scp=76249107456&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76249107456&partnerID=8YFLogxK
U2 - 10.1002/cncr.24845
DO - 10.1002/cncr.24845
M3 - Article
C2 - 20041482
AN - SCOPUS:76249107456
VL - 116
SP - 852
EP - 862
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 4
ER -