Progression‐free Survival at 24 Months as a Landmark After Autologous Stem Cell Transplant in Relapsed or Refractory Diffuse Large B‐cell Lymphoma
Year: 2021
Type: article
Abstract: after the second line of therapy (PFS2/OS2), and secondary malignancies (SM) rate.Non-parametric Kaplan-Meier estimator was used for the PFS, OS, PFS2 and OS2.Results: Between December 2003 and December 2012, 600 pts were randomized in LNH03-6B trial in four countries.304 and 296 pts intended to receive 8 cycles of R-CHOP14 or R-CHOP21, respectively.LT outcomes data were investigated for 164/259 (63%) pts eligible to the LTFU program (lost to follow-up: n = 92, pts' opposition: n = 3).With a median follow-up of 10.1 yrs, 213 pts progressed including 87 pts with a primary refractory disease and 140 pts died without progression.Ten-year PFS was: 41% (95% CI: 35-47) in the R-CHOP14 group and 40% (33-46) in the R-CHOP21 group (p = 0.92, Figure 1A).Ten-year OS was based on 302 deaths, and estimated as 50% (43-56) in both randomization groups (p = 0.98).Causes of death were similar in the two groups, mainly represented by lymphoma (43%).SM occurred in 73 (12%) pts including 18 squamous cell carcinoma.Salvage regimens were at the discretion of the investigators.Data from 194 of the 213 pts were analyzed.Two main sets were identified in this analysis: intensive chemotherapy (R-DHAOX/R-ICE/ R-ESHAP, n = 99) and standard chemotherapy (R-GEMOX, R-BENDAMUSTINE, n = 72.Rituximab was used in 2 nd line in 134 pts (71%) and radiotherapy in 28 pts (14%).Twenty pts (10%) received ASCT (median age at randomization: 64 yrs).105 pts /213 (49%) progressed after 2 nd line therapy and 77 pts died without a second progression (36%).The 2-yr PFS2 and OS2 probabilities were 21% (16-27, Figure 1B) and 39% (32-45), respectively.2-yr PFS2 in the set of ASCT recipients was 60% (36-78).Conclusions: PFS and OS were similar between groups 10 yrs after randomization.Progression leaded to very unfavorable prognosis except for a small set of selected pts that received ASCT.New alternatives, including CAR-T cells therapy, need to be explored as a second line treatment in this population.
Source: Hematological Oncology
DOI: 10.1002/hon.97_2880
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3173748339