Outcomes of Relapsed/Refractory B-Cell Lymphoma Is Improved by Salvage Chemotherapy Consisting of Two to Three Cycles of Dexamethasone (D), High Dose Ara-C (HA) and Carboplatin (DHAC) with or without Rituximab (R) Followed by Autologous Stem Cell Transplantation.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5130-5130
Author(s):  
Swaminathan Padmanabhan ◽  
Anjana Elefante ◽  
Prakash Varadarajan ◽  
Minoo Battiwalla ◽  
Arvinder Bir ◽  
...  
Keyword(s):  
Overall Survival ◽  
Stem Cell ◽  
B Cell ◽  
Median Survival ◽  
Salvage Therapy ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Overall Response

Abstract Introduction: Relapsed/refractory B-cell lymphomas are challenging to treat but can be salvaged by High- dose chemotherapy and stem cell transplant (HDC-SCT). Various non-cross resistant salvage regimens have been developed to treat patients with relapsed/refractory B-cell lymphoma. In this report we present our institution’s experience with DHAC ± R in patients requiring salvage therapy prior to HDC-SCT. Methods: The DHAC regimen consists of Dexamethasone at 15mg/m2/dose po every 6 hrs x 10 doses, High-dose Ara-C at 3G/m2 (1.5G/m2 if >50 yrs old) iv over 3 hrs every 12 hrs for 4 doses and Carboplatin at 200mg/m2 iv every 24 hrs for 2 doses. When utilized, patients received rituximab at the standard dose of 375mg/m2, 48 hrs prior to each cycle of DHAC. Growth factor support and anti-microbial prophylaxis was implemented 24 hrs after completion of chemotherapy. The regimen was repeated every 21 days for 2-3 cycles prior to HDC-SCT. We treated 37patients with relapsed/refractory lymphomas; median age was 47 yrs (range 18 – 78); 25 male and 19 females. Histological subtypes included (DLBCL (n=16); follicular lymphoma (n=10); marginal zone lymphoma with blastoid features (n=1); small lymphocytic lymphoma (n=1) and Hodgkin’s lymphoma (n=8). The majority of the patients presented with Stage III (n=43%), Stage IV (n=39%) at the time of DHAC therapy. Seventeen patients were treated with R+DHAC, and 20 were treated with DHAC, either as second line or third line salvage therapy. 19 of 37 proceeded to HD-SCT. Results: The overall response rate (ORR, CR+PR) for all patients was 61% (16 CR and 7 PR). The remaining 14 patients had either stable disease (n=10) or progressed (n=4). Complete responders (43%) had a longer median survival of 107 (range 78 – 136) months compared to 66 months (range 49 – 83) for partial responders (19 percent) and non-responders who had a mean survival of 30.8 months (range 9–54),[P = 0.008]. Patients who proceeded to HD-SCT had an ORR of 79% [11CR and 4 PR] compared to only 44% in those who did not [5 CR and 3 PR]. The median survival in patients transplanted was longer than non-transplanted patients (92 vs 68 months). Conclusions: DHAC with or without rituximab appears to be an effective salvage treatment for patients with relapsed or refractory advanced-stage B-lymphoma undergoing HDC-SCT. An overall response of 61% which increases to 79% when followed by autologous SCT were demonstrated. Median survival was longer in patients experiencing CRs compared to partial or non-responders suggesting that the quality and quantity of the cytoreduction after salvage chemotherapy is an important predictor factor of post-SCT survival. Data looking at prognostic factors predicting response to DHAC±R treatment are being analyzed and will be reported at the ASH annual meeting. Figure 1. Overall survival on DHAC±R depends on response to chemotheraphy. Figure 1. Overall survival on DHAC±R depends on response to chemotheraphy.

Dexamethasone (D), High Dose Ara-C (HA) and Carboplatin (DHAC) with or without Rituximab (R) Is an Effective Salvage Regimen for Patients with Relapsed/Refractory B-Cell Lymphoma in Preparation for Autologous Stem Cell Transplantation.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4730-4730
Author(s):  
Raymond Cruz ◽  
Myron S. Czuczman ◽  
Francisco Hernandez ◽  
Ajay Kanra ◽  
Swaminathan Padmanabhan
Keyword(s):  
Stem Cell ◽  
B Cell ◽  
Median Survival ◽  
Overall Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Cell Transplant ◽  
Overall Response

Abstract Introduction: Relapsed/refractory B-cell lymphomas are a constant treatment challenge. High- dose chemotherapy and stem cell transplant (HDC-SCT) continues to be the backbone of treatment for such patients. Adequate cytoreduction with salvage chemotherapy is necessary prior to HDC-SCT and its achievement has been demonstrated to correlate with post-transplant outcomes. Various non-cross resistant salvage regimens have been developed to treat patients with relapsed/refractory B-cell lymphoma. In this report we present our institution’s experience with DHAC±R in patients requiring salvage therapy prior to HDC-SCT. Methods: The DHAC regimen consists of Dexamethasone at 15mg/m2/dose po every 6 hours × 10 doses, High-dose Ara-C at 3gr/m2 (1.5gr/m2 if >50 yrs old) iv over 3 hrs every 12 hrs for 4 doses and Carboplatin at 200mg/m2 iv every 24 hrs for 2 doses. When utilized, patients received rituximab at the standard dose of 375mg/m2, 48 hrs prior to each cycle of DHAC. Growth factor support and anti-microbial prophylaxis was implemented 24 hours after completion of chemotherapy. The regimen was repeated every 21 days for 2-3 cycles prior to HDC-SCT. We treated 37 patients with relapsed/refractory lymphomas, the median age of the entire cohort was 47 years (range 18 – 78); 25 were male and 19 females. While most of the patients treated had diffuse large B-cell lymphoma (DLBCL), various histological subtypes were included (DLBCL (n=16); follicular lymphoma (n=10); marginal zone lymphoma with blastoid features (n=1); small lymphocytic lymphoma (n=1) and Hodgkin’s lymphoma (n=8). The majority of the patients presented with advance stage at the time of DHAC therapy-Stage III (n=43%), Stage IV (n=39%). Seventeen patients were treated with R+DHAC, and 20 were treated with DHAC, either as second line or third line therapy. 19 out of the 37 patients proceeded to Stem cell transplant (SCT). Results: The overall response rate (ORR, CR+PR) for all patients was 61%(CR (n=16); and PR (n=7). The remaining 14 patients had either stable disease (n=10) or progressed (n=4). Complete responders (43%) had a longer mean survival of 107 (range 78 – 136) months compared to 66 months (range 49 – 83) for partial responders (19 percent) and non-responders who had a mean survival of 30.8 months (range 9–54), [P = 0.008]. Patients who proceeded to SCT had an overall response rate of 79% [CR (n=11) and PR (n=4)] compared to only 44% in those who did not [CR (n=5) and PR (n=3)]. The median survival in patients transplanted was longer than non-transplanted patients (92 vs 68 months). Response rates and median survival was similar between patients receiving R-DHAC or DHAC. As expected grade 3&4 hematologic toxicities were seen and effectively managed with appropriate supportive care. Conclusions: DHAC with or without rituximab appears to be an effective salvage treatment for patients with relapsed or refractory advanced-stage B-lymphoma undergoing HDC-SCT. An overall response of 61% which increases to 79% when followed by autologous SCT were demonstrated. Median survival was longer in patients experiencing CRs compared to partial or non-responders suggesting that the quality and quantity of the cytoreduction after salvage chemotherapy is an important predictor factor of post-SCT survival. Data looking at prognostic factors predicting response to DHAC±R treatment are being analyzed and will be reported at the ASH annual meeting.

scholarly journals Rituximab Maintenance Therapy After Autologous Stem-Cell Transplantation in Patients With Relapsed CD20+ Diffuse Large B-Cell Lymphoma: Final Analysis of the Collaborative Trial in Relapsed Aggressive Lymphoma

2012 ◽  
Vol 30 (36) ◽  
pp. 4462-4469 ◽  
Author(s):  
Christian Gisselbrecht ◽  
Norbert Schmitz ◽  
Nicolas Mounier ◽  
Devinder Singh Gill ◽  
David C. Linch ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Large B Cell Lymphoma ◽  
Relapsed Disease ◽  
Large B Cell

Purpose The standard treatment for relapsed diffuse large B-cell lymphoma (DLBCL) is salvage chemotherapy followed by high-dose therapy and autologous stem-cell transplantation (ASCT). The impact of maintenance rituximab after ASCT is not known. Patients and Methods In total, 477 patients with CD20+ DLBCL who were in their first relapse or refractory to initial therapy were randomly assigned to one of two salvage regimens. After three cycles of salvage chemotherapy, the responding patients received high-dose chemotherapy followed by ASCT. Then, 242 patients were randomly assigned to either rituximab every 2 months for 1 year or observation. Results After ASCT, 122 patients received rituximab, and 120 patients were observed only. The median follow-up time was 44 months. The 4-year event-free survival (EFS) rates after ASCT were 52% and 53% for the rituximab and observation groups, respectively (P = .7). Treatment with rituximab was associated with a 15% attributable risk of serious adverse events after day 100, with more deaths (six deaths v three deaths in the observation arm). Several factors affected EFS after ASCT (P < .05), including relapsed disease within 12 months (EFS: 46% v 56% for relapsed disease after 12 months), secondary age-adjusted International Prognostic Index (saaIPI) more than 1 (EFS: 37% v 61% for saaIPI < 1), and prior treatment with rituximab (EFS: 47% v 59% for no prior rituximab). A significant difference in EFS between women (63%) and men (46%) was also observed in the rituximab group. In the Cox model for maintenance, the saaIPI was a significant prognostic factor (P < .001), as was male sex (P = .01). Conclusion In relapsed DLBCL, we observed no difference between the control group and the rituximab maintenance group and do not recommend rituximab after ASCT.

Treosulfan-Based Tandem High-Dose Chemo-Immuno- Therapy with Autologous Stem Cell Transplantation for Relapsed and Refractory Aggressive B-Cell Lymphomas.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5488-5488 ◽  
Author(s):  
Albrecht Reichle ◽  
Ernst Holler ◽  
Anna Berand ◽  
Reinhard Andreesen
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cell Transplantation ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Unrelated Donor ◽  
B Cell Lymphomas ◽  
Poor Risk

Abstract Feasibility and high efficacy of repetitive dose-intensive chemo-immuno-therapy in relapsed and refractory aggressive B-cell lymphoma (adjusted IPI at relapse 2 and 3) was proven by double-induction followed by tandem high-dose chemo-immuno-therapy with stem cell transplantation including a treosulfan-based conditioning regimen. For cytoreduction and stem cell mobilisation, 2 cycles of a cisplatin-based chemotherapy plus rituximab (R), R-VIPE or R-DHAP, were applied followed by two identical cycles of high-dose chemotherapy (HD-CT) consisting of treosulfan 14 g/m2 iv day −4 to day -2, carboplatin 300 mg/m2 iv day −4 to day −2 and etoposide 500 mg/m2 iv day −2 to day −4. Each HD-CT was combined with rituximab 375 mg/m2. Thirty patients (pts), mean age 53 years (range 35–68), stage III: n=9, stage IV: n=21, have been enrolled. 80% of the pts suffered from early relapse within 6 months (n=6) or refractory disease and no available matched related or unrelated donor (n=18), 6 pts had a late relapse (≥ 6 months). All patients received previously CHOP-based CTs. Histology revealed diffuse-large cell lymphoma (n=19), follicular lymphoma Grade 3 (n=6), immunoblastic lymphoma (n=3), and mantle cell lymphoma (n=2). In 7 pts both, low- and high-grade lymphomas were observed. Only one stem cell mobilization was necessary to collect sufficient CD34+ cells for two transplantations. Median hematologic recovery (&gt; 1.0 leukocytes/nl and platelets &gt;20/nl) after 1st and 2nd HD-CT was achieved by day 10 (8–11). No therapy-related death occurred. CTC °III and °IV non-hematologic toxicities were as follows: 11 of 29 pts after 1st HD-CT had °III toxicities (infection, vomiting, enteritis, stomatitis, diarrhea), after 2nd HD-CT 10 of 27 pts, respectively. Complete remission (CR 3 months post transplantation) was achieved in 22 of 30 pts (73%). CR was documented after double-induction (n=2), 1st HD-CT (n=9), and 2nd HD-CT (n=11), PR in 6 pts, and 2 pts had progressive disease during induction CT and HD-CT, respectively. At a median observation time of 19 months (range 3.6 to 4.6 months) 26 pts (87%) are alive. Sequential R-HD-CT results (in poor risk pts) in a median PFS of 14.0 months (CI 8.7 to 19.3 months), median overall survival (OS, intent-to-treat analysis) has not been reached (at 4 years 72%). In conclusion, treosulfan-based tandem R-HD-CT is feasible with a manageable toxicity profile. CR and continuous CR rates argue for a dose-response relationship even in high-risk patients with aggressive B-cell lymphomas. Some poor risk pts seem to be cured with the treosulfan-based HD-chemo-immuno-therapy. In cases of progression rescue therapies may be successfully administered as shown by the favorable OS rate. This study has now been extended as a multicenter trial.

Herpesviridae Viral Infections Following Chemotherapy in Patients with Lymphoma : Incidence, Risk Factors, and Prevention.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3704-3704
Author(s):  
Ho Sup Lee ◽  
Ji Young Park ◽  
Seong Hoon Shin ◽  
Sung Bin Kim ◽  
Aeran Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Cumulative Dose ◽  
Low Dose ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
Neutropenic Fever ◽  
High Dose ◽  
Acyclovir Prophylaxis

Abstract Abstract 3704 Poster Board III-640 Abstract Backgroud Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection(HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with lymphoma undergoing chemotherapy. But there was no consensus on the dose and duration of antiviral agents prophylaxis in lymphoma undergoing chemotherapy. We retrospectively analyzed the incidence, the risk factors and the prevention with low-dose acyclovir for HVI. Method A total of 266 patients who newly diagnosed and received an chemotherapy without prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, South Korea between June 1996 and August 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 54years (range 15-83 years) with a female-to-male ratio of 150:116. The enrolled diseases included diffuse large B cell lymphoma (DLBL, n=151, 56.8%), Hodgkin's disease (HD, n=16, 6.0%), T cell lymphoma (TCL, n=43, 16.2%) and other lymphoma (n=56, 21.1%) including mantle cell lymphoma, marzinal zone B cell lymphoma, follicular lymphoma, small lymphocytic lymphoma and burkitt's lymphoma. The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysises, we used logistic regression test. Results Fourty three patients (16.2%) developed HVI at a median of 5.43 months (range 0.43-51.33 months) after initial chemotherapy. In univariate analyses, risk factors for HVI were gender (p=0.002, 10% in male vs 24.1% in female), cumulative dose of prednisone (p < 0.001, 4.0% in less than 4000mg vs 31.6% in more than 4000mg), duration of chemotherapy (p=0.009, 11.8% in less than 6 months vs 24.0% in more than 6 months), presence of relapse (p=0.007, 24.7% in relapse vs 11.9% in non-relapse), receiving salvage chemotherapy (p=0.009, 11.8% in no receiving salvage chemotherapy vs 24.0% in receiving salvage chemotherapy), and presence of neutropenic fever (p=0.019, 26.9% in neutropenic fever vs 13.6% in no neutropenic fever). In multivariate analysis, the results confirmed 2 variables as independent predictive factors for the female (P < 0.001, hazard ratio (HR): 4.915, 95% confidence interval (CI) 2.200-10981) and cumulative dose of prednisone (P < 0.001, HR: 14.269, 95% CI 5.241-38.848). There was no different mortality rate and survival rate between HVI and non-HVI group. Conclusion Female and high dose prednisone was seemed to be high risk for HVI in patients with lymphoma undergoing chemotherapy without acyclovir prophylaxis. Low-dose acyclovir prophylaxis for HVI may be needed in higher risk lymphoma patients undergoing chemotherapy. Disclosures: No relevant conflicts of interest to declare.

Comparative Outcomes of Chemotherapy with and without HAART for HIV-Related B-Cell Lymphoma: A Meta-Analysis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4372-4372 ◽  
Author(s):  
Matthew J Ehrhardt ◽  
Janaki Y Shah ◽  
Yachiyo Kuwatsuka ◽  
Sailaja Kamaraju ◽  
Jeffrey L Jackson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Viral Load ◽  
Complete Remission ◽  
B Cell ◽  
Random Effects ◽  
Median Survival ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Cochrane Central Register

Abstract Background Human immunodeficiency virus (HIV) infected individuals have an increased incidence of malignancies, including B-cell lymphomas. The use of highly active antiretroviral therapy (HAART) during antineoplastic therapy for HIV related lymphoma remains controversial. The current meta-analysis investigates the impact of the upfront addition of HAART to chemotherapy on overall survival (OS) compared to chemotherapy alone. Methods We searched MEDLINE (January 1996 to May 2013), the Cochrane Central Register of Controlled Trials (May 2013), and the references of retrieved articles. Published clinical trials were included that both clearly defined the patients treated with and without HAART and provided the respective outcomes for each group. Two authors independently assessed the quality of studies and abstracted data. Primary outcomes were complete remission (CR) and overall survival (OS). Hazard ratios were pooled using random effects methods. Heterogeneity was assessed with I2 and by visual inspection of the Galbraith plots. Sources of heterogeneity were explored using stratified analysis and random-effects meta-regression. Results Four retrospective chart reviews, one retrospective case control, two cohort studies, one randomized trial, and two prospective trials were eligible for review, providing 1070 subjects with an average age of 41.3 years. The mean CD4 count was 223/μl and HIV viral load 192,452 copies/ml. There was significant heterogeneity between studies. Individuals receiving HAART were more likely to achieve CR compared to those not receiving HAART (RR 1.47, CI: 1.04-2.06, I2=75.0%). Among those receiving HAART, 56% (95% CI: 45%-67%, I2=67.8%) achieved CR compared to 37% (95% CI: 28%-45%, I2=75.1) not receiving HAART. The addition of HAART to chemotherapy improves OS when compared to those receiving chemotherapy alone (HR: 0.58, 95% CI: 0.49-0.68, I2=91.4%, Figure 1), representing an increased median OS time of 20.5 months (95% CI: 2.6-38.4, I2=93.6%). Calculation of a pooled HR using survival curve data from studies with extractable data yielded similar results (HR: 0.50, 95% CI: 0.41-0.61, Figure 2). Higher CD4 counts were associated with improved survival (p<0.0005). Conversely, older age (p=0.017), higher viral load (p<0.0005), higher stage lymphoma (p=0.023), the presence of B-symptoms (p<0.0005), and worse functional status (p<0.0005) were associated with decreased survival. Following adjustment for these predictors, concurrent HAART and chemotherapy resulted in improved OS (HR: 0.46, 95% CI: 0.38-0.57). There was no evidence of publication bias for any of our outcomes (CR: p=0.39, median survival: p=0.47, HR: p=0.07). There was also no relationship between quality and any of our outcomes (CR: p=0.77, median survival: p=0.32, HR: p=0.33). Conclusion Overall survival and complete remission are improved with the upfront addition of HAART to chemotherapy when compared to chemotherapy alone for patients with HIV related B-cell lymphoma. Disclosures: No relevant conflicts of interest to declare.

Stem Cell Dose and Time To Engraftment Does Not Predict Outcome After Autologous Stem Cell Transplantation For Relapsed Aggressive NHL

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5542-5542 ◽  
Author(s):  
Shane A Gangatharan ◽  
John Kuruvilla ◽  
Vishal Kukreti ◽  
Armand Keating ◽  
Manjula Maganti ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
B Cell ◽  
Research Funding ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
Entire Cohort ◽  
Cell Dose ◽  
Cd34 Cells

Abstract Introduction Autologous stem cell transplantation (ASCT) is the standard of care for relapsed aggressive lymphomas. Time to neutrophil and platelet engraftment is strongly correlated with CD34+ cell number infused but data are conflicting as to whether patients who receive greater numbers of CD34+ stem cells have improved outcomes. We sought to determine whether short term engraftment predicts progression-free survival (PFS) independent of other disease-specific prognostic factors. Methods From the Princess Margaret Cancer Centre transplant database, we identified patients undergoing ASCT for relapsed aggressive lymphoma between 2007-2011. Data were extracted on prognostic features at relapse/progression, stem cell collection, engraftment, and time to progression and death. All patients received platinum-based salvage chemotherapy and those with chemosensitivity were mobilised with cyclophosphamide, etoposide and filgrastim (minimum threshold 2x106 CD34 cells/kg) and proceeded to ASCT. Patients who failed initial mobilisation were remobilised using plerixafor. High-dose therapy consisted of etoposide 60mg/kg Day -4 and melphalan 180mg/m2 Day -3 with stem cells infused on Day 0. Filgrastim 300µg daily was started from Day +7 until neutrophil recovery to >1.0 x106/uL. Platelet engraftment was defined as an unsupported platelet count >20 x 109/L. Results 97 patients with DLBCL (n=66), transformed (n=24) and T-cell lymphoma (n=7) were reviewed. Median age was 54 (range 20-67), 61% were male and median IPI score on relapse was 2. Fifty one percent relapsed within 12 months of last therapy, and of the patients with B-cell lymphoma, 81% received rituximab prior to salvage chemotherapy. Median stem cell dose was 5.7x106 CD34+ cells/kg (range 1.69-17.82) with a median number of apheresis sessions to achieve this of 2 (range 1-4). Median time to neutrophils >0.5x106/uL was 11 days (range 9-14) and platelets >20x106/uL was 14 days (range 10-23). The Spearman correlation test confirmed a higher stem cell dose was significantly associated with shorter time to neutrophil (p=0.0014) and platelet engraftment (p=0.0003). From date of ASCT, median follow-up was 3.1 years in progression-free patients. For the entire cohort, PFS was 50% and overall survival (OS) was 74% at 3 years. On univariable analysis, patients with B-cell lymphoma with IPI score of 0-2 had a 3-year PFS of 59%, v 28% for those with IPI of 3-4 (p=0.03) (n=90). Patients with early relapse within 12 months of last therapy had inferior 3-year PFS, 42% v 59% for those with initial PFS > 1 year (p=0.08). Patients with B-cell lymphoma who received rituximab with primary chemotherapy had worse 3-year PFS: 47% v 69% (p=0.11). There were no associations of PFS with lymphoma subtype, dose of stem cells infused, number of apheresis sessions and neutrophil or platelet engraftment. Similarly, on univariable analysis of OS for the entire cohort, only secondary IPI (0-2 v 3-4) was significant, with 3-year OS 82% v 48%, respectively (p=0.01). Multivariable Cox regression analysis of outcomes for patients with B-cell lymphoma in a model including IPI score, time to relapse, prior rituximab, CD34+ cell dose and neutrophil and platelet engraftment times confirmed IPI was the only significant variable predicting PFS (HR 1.99, p=0.03) and OS (HR 3.2, p=0.006). Conclusions In this cohort of patients with aggressive lymphomas, CD34+ cell dose was correlated with time to neutrophil and platelet engraftment but was not predictive of PFS or OS. Secondary IPI score, relapse within 12 months, and for B-cell lymphomas previous use of rituximab were predictive of outcomes post ASCT. Disclosures: Kuruvilla: Roche: Honoraria. Kukreti:Millennium Pharmaceuticals: Research Funding; Onyx: Research Funding. Keating:Roche: Honoraria. Crump:Roche: Honoraria; Jansen-Ortho: Honoraria; Celgene: Honoraria; Lundbeck: Honoraria; Novartis: Research Funding; Seattle Genetics: Honoraria.

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