Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission: A report from the Autologous Blood and Marrow Transplant Registry

Julie Marie Vose, M. J. Zhang, P. A. Rowlings, H. M. Lazarus, B. J. Bolwell, C. O. Freytes, S. Pavlovsky, A. Keating, B. Yanes, K. Van Besien, James Olen Armitage, M. M. Horowitz, A. Bashey, I. Bence-Bruckler, L. J. Burns, J. W. Fay, R. P. Gale, J. Gibson, S. A. Giralt, S. GoldsteinR. H. Herzig, W. Hiddemann, R. Martino, P. L. McCarthy, A. Miller, G. Milone, E. Montserrat, A. Pecora, G. L. Phillips, A. D. Rubin, D. P. Schenkein, P. J. Stiff, D. H. Vesole, J. R. Wingard

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Abstract

Purpose: To evaluate the results of high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (autotransplants) in patients with diffuse aggressive non-Hodgkin's lymphoma (NHL) who never achieve a complete remission with conventional chemotherapy. Patients and Methods: Detailed records from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 184 patients with diffuse aggressive NHL who never achieved a complete remission with conventional chemotherapy and subsequently received an autotransplant were evaluated. Transplants were performed between 1989 and 1995 and were reported to the ABMTR by 48 centers in North and South America. Results: Seventy-nine (44%) of 184 patients achieved a complete remission or a complete remission with residual imaging abnormalities of unknown significance after autotransplantation. Thirty-four (19%) of 184 had a partial remission and 55 (31%) of 184 had no response or progressive disease. Eleven patients (6%) were not assessable for response because of early death. The probabilities of progression-free and overall survival at 5 years after transplantation were 31% (95% confidence interval [CI], 24% to 38%) and 37% (95% CI, 30% to 45%), respectively. In multivariate analysis, chemotherapy resistance, Karnofsky performance status score less than 80 at transplantation, age ≥ 55 years at transplantation, receiving three or more prior chemotherapy regimens, and not receiving pre- or posttransplant involved-field irradiation therapy were adverse prognostic factors for overall survival. Conclusion: High-dose chemotherapy and autologous hematopoietic stem-cell transplantation should be considered for patients with diffuse aggressive NHL who never achieve a complete remission but who are still chemotherapy-sensitive and are otherwise transplant candidates.

Original languageEnglish (US)
Pages (from-to)406-413
Number of pages8
JournalJournal of Clinical Oncology
Volume19
Issue number2
DOIs
StatePublished - Jan 15 2001

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Autologous Transplantation
Non-Hodgkin's Lymphoma
Registries
Bone Marrow
Transplants
Drug Therapy
Transplantation
Hematopoietic Stem Cell Transplantation
Autografts
Confidence Intervals
Karnofsky Performance Status
South America
North America
Disease-Free Survival
Multivariate Analysis
Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission : A report from the Autologous Blood and Marrow Transplant Registry. / Vose, Julie Marie; Zhang, M. J.; Rowlings, P. A.; Lazarus, H. M.; Bolwell, B. J.; Freytes, C. O.; Pavlovsky, S.; Keating, A.; Yanes, B.; Van Besien, K.; Armitage, James Olen; Horowitz, M. M.; Bashey, A.; Bence-Bruckler, I.; Burns, L. J.; Fay, J. W.; Gale, R. P.; Gibson, J.; Giralt, S. A.; Goldstein, S.; Herzig, R. H.; Hiddemann, W.; Martino, R.; McCarthy, P. L.; Miller, A.; Milone, G.; Montserrat, E.; Pecora, A.; Phillips, G. L.; Rubin, A. D.; Schenkein, D. P.; Stiff, P. J.; Vesole, D. H.; Wingard, J. R.

In: Journal of Clinical Oncology, Vol. 19, No. 2, 15.01.2001, p. 406-413.

Research output: Contribution to journalArticle

Vose, JM, Zhang, MJ, Rowlings, PA, Lazarus, HM, Bolwell, BJ, Freytes, CO, Pavlovsky, S, Keating, A, Yanes, B, Van Besien, K, Armitage, JO, Horowitz, MM, Bashey, A, Bence-Bruckler, I, Burns, LJ, Fay, JW, Gale, RP, Gibson, J, Giralt, SA, Goldstein, S, Herzig, RH, Hiddemann, W, Martino, R, McCarthy, PL, Miller, A, Milone, G, Montserrat, E, Pecora, A, Phillips, GL, Rubin, AD, Schenkein, DP, Stiff, PJ, Vesole, DH & Wingard, JR 2001, 'Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission: A report from the Autologous Blood and Marrow Transplant Registry', Journal of Clinical Oncology, vol. 19, no. 2, pp. 406-413. https://doi.org/10.1200/JCO.2001.19.2.406
Vose, Julie Marie ; Zhang, M. J. ; Rowlings, P. A. ; Lazarus, H. M. ; Bolwell, B. J. ; Freytes, C. O. ; Pavlovsky, S. ; Keating, A. ; Yanes, B. ; Van Besien, K. ; Armitage, James Olen ; Horowitz, M. M. ; Bashey, A. ; Bence-Bruckler, I. ; Burns, L. J. ; Fay, J. W. ; Gale, R. P. ; Gibson, J. ; Giralt, S. A. ; Goldstein, S. ; Herzig, R. H. ; Hiddemann, W. ; Martino, R. ; McCarthy, P. L. ; Miller, A. ; Milone, G. ; Montserrat, E. ; Pecora, A. ; Phillips, G. L. ; Rubin, A. D. ; Schenkein, D. P. ; Stiff, P. J. ; Vesole, D. H. ; Wingard, J. R. / Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission : A report from the Autologous Blood and Marrow Transplant Registry. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 2. pp. 406-413.
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abstract = "Purpose: To evaluate the results of high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (autotransplants) in patients with diffuse aggressive non-Hodgkin's lymphoma (NHL) who never achieve a complete remission with conventional chemotherapy. Patients and Methods: Detailed records from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 184 patients with diffuse aggressive NHL who never achieved a complete remission with conventional chemotherapy and subsequently received an autotransplant were evaluated. Transplants were performed between 1989 and 1995 and were reported to the ABMTR by 48 centers in North and South America. Results: Seventy-nine (44{\%}) of 184 patients achieved a complete remission or a complete remission with residual imaging abnormalities of unknown significance after autotransplantation. Thirty-four (19{\%}) of 184 had a partial remission and 55 (31{\%}) of 184 had no response or progressive disease. Eleven patients (6{\%}) were not assessable for response because of early death. The probabilities of progression-free and overall survival at 5 years after transplantation were 31{\%} (95{\%} confidence interval [CI], 24{\%} to 38{\%}) and 37{\%} (95{\%} CI, 30{\%} to 45{\%}), respectively. In multivariate analysis, chemotherapy resistance, Karnofsky performance status score less than 80 at transplantation, age ≥ 55 years at transplantation, receiving three or more prior chemotherapy regimens, and not receiving pre- or posttransplant involved-field irradiation therapy were adverse prognostic factors for overall survival. Conclusion: High-dose chemotherapy and autologous hematopoietic stem-cell transplantation should be considered for patients with diffuse aggressive NHL who never achieve a complete remission but who are still chemotherapy-sensitive and are otherwise transplant candidates.",
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T1 - Autologous transplantation for diffuse aggressive non-Hodgkin's lymphoma in patients never achieving remission

T2 - A report from the Autologous Blood and Marrow Transplant Registry

AU - Vose, Julie Marie

AU - Zhang, M. J.

AU - Rowlings, P. A.

AU - Lazarus, H. M.

AU - Bolwell, B. J.

AU - Freytes, C. O.

AU - Pavlovsky, S.

AU - Keating, A.

AU - Yanes, B.

AU - Van Besien, K.

AU - Armitage, James Olen

AU - Horowitz, M. M.

AU - Bashey, A.

AU - Bence-Bruckler, I.

AU - Burns, L. J.

AU - Fay, J. W.

AU - Gale, R. P.

AU - Gibson, J.

AU - Giralt, S. A.

AU - Goldstein, S.

AU - Herzig, R. H.

AU - Hiddemann, W.

AU - Martino, R.

AU - McCarthy, P. L.

AU - Miller, A.

AU - Milone, G.

AU - Montserrat, E.

AU - Pecora, A.

AU - Phillips, G. L.

AU - Rubin, A. D.

AU - Schenkein, D. P.

AU - Stiff, P. J.

AU - Vesole, D. H.

AU - Wingard, J. R.

PY - 2001/1/15

Y1 - 2001/1/15

N2 - Purpose: To evaluate the results of high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (autotransplants) in patients with diffuse aggressive non-Hodgkin's lymphoma (NHL) who never achieve a complete remission with conventional chemotherapy. Patients and Methods: Detailed records from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 184 patients with diffuse aggressive NHL who never achieved a complete remission with conventional chemotherapy and subsequently received an autotransplant were evaluated. Transplants were performed between 1989 and 1995 and were reported to the ABMTR by 48 centers in North and South America. Results: Seventy-nine (44%) of 184 patients achieved a complete remission or a complete remission with residual imaging abnormalities of unknown significance after autotransplantation. Thirty-four (19%) of 184 had a partial remission and 55 (31%) of 184 had no response or progressive disease. Eleven patients (6%) were not assessable for response because of early death. The probabilities of progression-free and overall survival at 5 years after transplantation were 31% (95% confidence interval [CI], 24% to 38%) and 37% (95% CI, 30% to 45%), respectively. In multivariate analysis, chemotherapy resistance, Karnofsky performance status score less than 80 at transplantation, age ≥ 55 years at transplantation, receiving three or more prior chemotherapy regimens, and not receiving pre- or posttransplant involved-field irradiation therapy were adverse prognostic factors for overall survival. Conclusion: High-dose chemotherapy and autologous hematopoietic stem-cell transplantation should be considered for patients with diffuse aggressive NHL who never achieve a complete remission but who are still chemotherapy-sensitive and are otherwise transplant candidates.

AB - Purpose: To evaluate the results of high-dose chemotherapy and autologous hematopoietic stem-cell transplantation (autotransplants) in patients with diffuse aggressive non-Hodgkin's lymphoma (NHL) who never achieve a complete remission with conventional chemotherapy. Patients and Methods: Detailed records from the Autologous Blood and Marrow Transplant Registry (ABMTR) on 184 patients with diffuse aggressive NHL who never achieved a complete remission with conventional chemotherapy and subsequently received an autotransplant were evaluated. Transplants were performed between 1989 and 1995 and were reported to the ABMTR by 48 centers in North and South America. Results: Seventy-nine (44%) of 184 patients achieved a complete remission or a complete remission with residual imaging abnormalities of unknown significance after autotransplantation. Thirty-four (19%) of 184 had a partial remission and 55 (31%) of 184 had no response or progressive disease. Eleven patients (6%) were not assessable for response because of early death. The probabilities of progression-free and overall survival at 5 years after transplantation were 31% (95% confidence interval [CI], 24% to 38%) and 37% (95% CI, 30% to 45%), respectively. In multivariate analysis, chemotherapy resistance, Karnofsky performance status score less than 80 at transplantation, age ≥ 55 years at transplantation, receiving three or more prior chemotherapy regimens, and not receiving pre- or posttransplant involved-field irradiation therapy were adverse prognostic factors for overall survival. Conclusion: High-dose chemotherapy and autologous hematopoietic stem-cell transplantation should be considered for patients with diffuse aggressive NHL who never achieve a complete remission but who are still chemotherapy-sensitive and are otherwise transplant candidates.

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