Long-Term Outcomes of Autologous Stem Cell Transplantation for Follicular Non-Hodgkin Lymphoma

Effect of Histological Grade and Follicular International Prognostic Index

Julie Marie Vose, Philip Jay Bierman, Fausto R. Loberiza, James C. Lynch, Robert G Bociek, Dennis D. Weisenburger, James Olen Armitage

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Although results of autologous stem cell transplantation (SCT) for recurrent follicular non-Hodgkin lymphoma (NHL) have been previously reported, the long-term results and evaluation of prognostic factors in a large patient population receiving this therapy are difficult to find in the literature. To address these issues, we evaluated 248 patients with recurrent follicular NHL treated with high-dose chemotherapy and autologous SCT between 7/87 and 6/03. According to the World Health Organization (WHO) classification system, 64 patients (26%) had follicular NHL grade 1 (FL 1), 98 (40%) had FL 2, and 86 (35%) had FL 3. At the time of transplantation, 88 of the patients (35%) had a Follicular Lymphoma International Prognostic Index (FLIPI) score of low risk, 87 (35%) had an intermediate-risk FLIPI score, 37 (15%) had a high-risk FLIPI score, and 36 (15%) had at least 1 missing value, preventing calculation of the FLIPI score. The 5-year overall survival (OS) for all patients was 63%, and the 5-year progression-free survival (PFS) was 44%. In a multivariate analysis, a histological grade of FL 3, a high-risk FLIPI score at the time of transplantation, and having received 3 or more previous chemotherapy regimens were significant factors for predicting a worse OS. In addition, the use of a transplantation regimen including a monoclonal antibody decreased the relative risk of progressive lymphoma. These data suggest that transplantation earlier in the course of the disease for patients with follicular lymphoma with use of a monoclonal antibody-based regimen may lead to improved outcomes.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2008

Fingerprint

Follicular Lymphoma
Stem Cell Transplantation
Non-Hodgkin's Lymphoma
Transplantation
Monoclonal Antibodies
Drug Therapy
Survival
Disease-Free Survival
Lymphoma
Multivariate Analysis

Keywords

  • Autologous stem cell transplantation
  • Follicular
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

@article{7a33398d3a0047fca02b8ab7f0e63424,
title = "Long-Term Outcomes of Autologous Stem Cell Transplantation for Follicular Non-Hodgkin Lymphoma: Effect of Histological Grade and Follicular International Prognostic Index",
abstract = "Although results of autologous stem cell transplantation (SCT) for recurrent follicular non-Hodgkin lymphoma (NHL) have been previously reported, the long-term results and evaluation of prognostic factors in a large patient population receiving this therapy are difficult to find in the literature. To address these issues, we evaluated 248 patients with recurrent follicular NHL treated with high-dose chemotherapy and autologous SCT between 7/87 and 6/03. According to the World Health Organization (WHO) classification system, 64 patients (26{\%}) had follicular NHL grade 1 (FL 1), 98 (40{\%}) had FL 2, and 86 (35{\%}) had FL 3. At the time of transplantation, 88 of the patients (35{\%}) had a Follicular Lymphoma International Prognostic Index (FLIPI) score of low risk, 87 (35{\%}) had an intermediate-risk FLIPI score, 37 (15{\%}) had a high-risk FLIPI score, and 36 (15{\%}) had at least 1 missing value, preventing calculation of the FLIPI score. The 5-year overall survival (OS) for all patients was 63{\%}, and the 5-year progression-free survival (PFS) was 44{\%}. In a multivariate analysis, a histological grade of FL 3, a high-risk FLIPI score at the time of transplantation, and having received 3 or more previous chemotherapy regimens were significant factors for predicting a worse OS. In addition, the use of a transplantation regimen including a monoclonal antibody decreased the relative risk of progressive lymphoma. These data suggest that transplantation earlier in the course of the disease for patients with follicular lymphoma with use of a monoclonal antibody-based regimen may lead to improved outcomes.",
keywords = "Autologous stem cell transplantation, Follicular, Non-Hodgkin lymphoma",
author = "Vose, {Julie Marie} and Bierman, {Philip Jay} and Loberiza, {Fausto R.} and Lynch, {James C.} and Bociek, {Robert G} and Weisenburger, {Dennis D.} and Armitage, {James Olen}",
year = "2008",
month = "1",
day = "1",
doi = "10.1016/j.bbmt.2007.06.016",
language = "English (US)",
volume = "14",
pages = "36--42",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Long-Term Outcomes of Autologous Stem Cell Transplantation for Follicular Non-Hodgkin Lymphoma

T2 - Effect of Histological Grade and Follicular International Prognostic Index

AU - Vose, Julie Marie

AU - Bierman, Philip Jay

AU - Loberiza, Fausto R.

AU - Lynch, James C.

AU - Bociek, Robert G

AU - Weisenburger, Dennis D.

AU - Armitage, James Olen

PY - 2008/1/1

Y1 - 2008/1/1

N2 - Although results of autologous stem cell transplantation (SCT) for recurrent follicular non-Hodgkin lymphoma (NHL) have been previously reported, the long-term results and evaluation of prognostic factors in a large patient population receiving this therapy are difficult to find in the literature. To address these issues, we evaluated 248 patients with recurrent follicular NHL treated with high-dose chemotherapy and autologous SCT between 7/87 and 6/03. According to the World Health Organization (WHO) classification system, 64 patients (26%) had follicular NHL grade 1 (FL 1), 98 (40%) had FL 2, and 86 (35%) had FL 3. At the time of transplantation, 88 of the patients (35%) had a Follicular Lymphoma International Prognostic Index (FLIPI) score of low risk, 87 (35%) had an intermediate-risk FLIPI score, 37 (15%) had a high-risk FLIPI score, and 36 (15%) had at least 1 missing value, preventing calculation of the FLIPI score. The 5-year overall survival (OS) for all patients was 63%, and the 5-year progression-free survival (PFS) was 44%. In a multivariate analysis, a histological grade of FL 3, a high-risk FLIPI score at the time of transplantation, and having received 3 or more previous chemotherapy regimens were significant factors for predicting a worse OS. In addition, the use of a transplantation regimen including a monoclonal antibody decreased the relative risk of progressive lymphoma. These data suggest that transplantation earlier in the course of the disease for patients with follicular lymphoma with use of a monoclonal antibody-based regimen may lead to improved outcomes.

AB - Although results of autologous stem cell transplantation (SCT) for recurrent follicular non-Hodgkin lymphoma (NHL) have been previously reported, the long-term results and evaluation of prognostic factors in a large patient population receiving this therapy are difficult to find in the literature. To address these issues, we evaluated 248 patients with recurrent follicular NHL treated with high-dose chemotherapy and autologous SCT between 7/87 and 6/03. According to the World Health Organization (WHO) classification system, 64 patients (26%) had follicular NHL grade 1 (FL 1), 98 (40%) had FL 2, and 86 (35%) had FL 3. At the time of transplantation, 88 of the patients (35%) had a Follicular Lymphoma International Prognostic Index (FLIPI) score of low risk, 87 (35%) had an intermediate-risk FLIPI score, 37 (15%) had a high-risk FLIPI score, and 36 (15%) had at least 1 missing value, preventing calculation of the FLIPI score. The 5-year overall survival (OS) for all patients was 63%, and the 5-year progression-free survival (PFS) was 44%. In a multivariate analysis, a histological grade of FL 3, a high-risk FLIPI score at the time of transplantation, and having received 3 or more previous chemotherapy regimens were significant factors for predicting a worse OS. In addition, the use of a transplantation regimen including a monoclonal antibody decreased the relative risk of progressive lymphoma. These data suggest that transplantation earlier in the course of the disease for patients with follicular lymphoma with use of a monoclonal antibody-based regimen may lead to improved outcomes.

KW - Autologous stem cell transplantation

KW - Follicular

KW - Non-Hodgkin lymphoma

UR - http://www.scopus.com/inward/record.url?scp=37349106713&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37349106713&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2007.06.016

DO - 10.1016/j.bbmt.2007.06.016

M3 - Article

VL - 14

SP - 36

EP - 42

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 1

ER -