Outcomes of diffuse large B-cell lymphoma patients relapsing after autologous stem cell transplantation: an analysis of patients included in the CORAL study.
Identifieur interne : 000665 ( Main/Exploration ); précédent : 000664; suivant : 000666Outcomes of diffuse large B-cell lymphoma patients relapsing after autologous stem cell transplantation: an analysis of patients included in the CORAL study.
Auteurs : E. Van Den Neste [Belgique] ; N. Schmitz [Allemagne] ; N. Mounier [France] ; D. Gill [Australie] ; D. Linch [Royaume-Uni] ; M. Trneny [République tchèque] ; R. Bouadballah [France] ; J. Radford [Royaume-Uni] ; M. Bargetzi [Suisse] ; V. Ribrag [France] ; U. Dührsen [Allemagne] ; D. Ma [Australie] ; J. Briere [France] ; C. Thieblemont [France] ; E. Bachy [France] ; C H Moskowitz [États-Unis] ; B. Glass [Allemagne] ; C. Gisselbrecht [France]Source :
- Bone marrow transplantation [ 1476-5365 ] ; 2017.
Abstract
In the CORAL study, 255 chemosensitive relapses with diffuse large B-cell lymphoma (DLBCL) were consolidated with autologous stem cell transplantation (ASCT), and 75 of them relapsed thereafter. The median time between ASCT and progression was 7.1 months. The median age was 56.1 years; tertiary International Prognosis Index (tIPI) observed at relapse was 0-2 in 71.6% of the patients and >2 in 28.4%. The overall response rate to third-line chemotherapy was 44%. The median overall survival (OS) was 10.0 months (median follow-up: 32.8 months). Thirteen patients received an allogeneic SCT, and three a second ASCT. The median OS was shorter among patients who relapsed <6 months (5.7 months) compared with those relapsing ⩾12 months after ASCT (12.6 months, P=0.0221). The median OS in patients achieving CR, PR or no response after the third-line regimen was 37.7 (P<0.0001), 10.0 (P=0.03) and 6.3 months, respectively. The median OS varied according to tIPI: 0-2: 12.6 months and >2: 5.3 months (P=0.0007). In multivariate analysis, tIPI >2, achievement of response and remission lasting <6 months predicted the OS. This report identifies the prognostic factors for DLBCL relapsing after ASCT and thus helps to select patients for experimental therapy.
DOI: 10.1038/bmt.2016.213
PubMed: 27643872
Affiliations:
- Allemagne, Australie, Belgique, France, Royaume-Uni, République tchèque, Suisse, États-Unis
- Angleterre, Bohême centrale, Grand Londres, Grand Manchester, Hambourg, Provence-Alpes-Côte d'Azur, Région de Bruxelles-Capitale, État de New York, Île-de-France
- Bruxelles, Hambourg, Londres, Manchester, Marseille, Nice, Paris, Prague
- University College de Londres
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Van Den Neste</name><affiliation wicri:level="3"><nlm:affiliation>Cliniques Universitaires UCL Saint-Luc, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Cliniques Universitaires UCL Saint-Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Schmitz, N" sort="Schmitz, N" uniqKey="Schmitz N" first="N" last="Schmitz">N. Schmitz</name><affiliation wicri:level="3"><nlm:affiliation>AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Mounier, N" sort="Mounier, N" uniqKey="Mounier N" first="N" last="Mounier">N. Mounier</name><affiliation wicri:level="3"><nlm:affiliation>CHU de l'Archet, route de St Antoine-Ginestiere, Nice, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CHU de l'Archet, route de St Antoine-Ginestiere, Nice</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Nice</settlement></placeName></affiliation></author><author><name sortKey="Gill, D" sort="Gill, D" uniqKey="Gill D" first="D" last="Gill">D. Gill</name><affiliation wicri:level="1"><nlm:affiliation>Princess Alexandra Hospital, Woodville, South Australia, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Princess Alexandra Hospital, Woodville, South Australia</wicri:regionArea><wicri:noRegion>South Australia</wicri:noRegion></affiliation></author><author><name sortKey="Linch, D" sort="Linch, D" uniqKey="Linch D" first="D" last="Linch">D. Linch</name><affiliation wicri:level="4"><nlm:affiliation>University College London, Cancer Institute, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University College London, Cancer Institute, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Trneny, M" sort="Trneny, M" uniqKey="Trneny M" first="M" last="Trneny">M. Trneny</name><affiliation wicri:level="3"><nlm:affiliation>Charles University and General Hospital, Praha, Czech Republic.</nlm:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Charles University and General Hospital, Praha</wicri:regionArea><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Bouadballah, R" sort="Bouadballah, R" uniqKey="Bouadballah R" first="R" last="Bouadballah">R. Bouadballah</name><affiliation wicri:level="3"><nlm:affiliation>Institut Paoli Calmette Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut Paoli Calmette Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Radford, J" sort="Radford, J" uniqKey="Radford J" first="J" last="Radford">J. Radford</name><affiliation wicri:level="3"><nlm:affiliation>University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Bargetzi, M" sort="Bargetzi, M" uniqKey="Bargetzi M" first="M" last="Bargetzi">M. Bargetzi</name><affiliation wicri:level="1"><nlm:affiliation>Hämatologie, Kantonsspital Aarau, Aarau, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Hämatologie, Kantonsspital Aarau, Aarau</wicri:regionArea><wicri:noRegion>Aarau</wicri:noRegion></affiliation></author><author><name sortKey="Ribrag, V" sort="Ribrag, V" uniqKey="Ribrag V" first="V" last="Ribrag">V. Ribrag</name><affiliation wicri:level="1"><nlm:affiliation>Institut Gustave Roussy, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut Gustave Roussy, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Duhrsen, U" sort="Duhrsen, U" uniqKey="Duhrsen U" first="U" last="Dührsen">U. Dührsen</name><affiliation wicri:level="1"><nlm:affiliation>Universitätsklinikum Essen, KlinikfürHämatologie-Hufelandstraße, Essen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Universitätsklinikum Essen, KlinikfürHämatologie-Hufelandstraße, Essen</wicri:regionArea><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Ma, D" sort="Ma, D" uniqKey="Ma D" first="D" last="Ma">D. Ma</name><affiliation wicri:level="1"><nlm:affiliation>St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>St Vincent's Hospital Sydney, Darlinghurst, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Briere, J" sort="Briere, J" uniqKey="Briere J" first="J" last="Briere">J. Briere</name><affiliation wicri:level="3"><nlm:affiliation>Hopital Saint Louis Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hopital Saint Louis Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Thieblemont, C" sort="Thieblemont, C" uniqKey="Thieblemont C" first="C" last="Thieblemont">C. Thieblemont</name><affiliation wicri:level="3"><nlm:affiliation>Hopital Saint Louis Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hopital Saint Louis Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bachy, E" sort="Bachy, E" uniqKey="Bachy E" first="E" last="Bachy">E. Bachy</name><affiliation wicri:level="1"><nlm:affiliation>Hospices Civils de Lyon, Université de Lyon, Pierre Benite, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hospices Civils de Lyon, Université de Lyon, Pierre Benite</wicri:regionArea><wicri:noRegion>Pierre Benite</wicri:noRegion><wicri:noRegion>Pierre Benite</wicri:noRegion></affiliation></author><author><name sortKey="Moskowitz, C H" sort="Moskowitz, C H" uniqKey="Moskowitz C" first="C H" last="Moskowitz">C H Moskowitz</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Glass, B" sort="Glass, B" uniqKey="Glass B" first="B" last="Glass">B. Glass</name><affiliation wicri:level="3"><nlm:affiliation>AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Gisselbrecht, C" sort="Gisselbrecht, C" uniqKey="Gisselbrecht C" first="C" last="Gisselbrecht">C. Gisselbrecht</name><affiliation wicri:level="3"><nlm:affiliation>Hopital Saint Louis Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hopital Saint Louis Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j">Bone marrow transplantation</title><idno type="eISSN">1476-5365</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In the CORAL study, 255 chemosensitive relapses with diffuse large B-cell lymphoma (DLBCL) were consolidated with autologous stem cell transplantation (ASCT), and 75 of them relapsed thereafter. The median time between ASCT and progression was 7.1 months. The median age was 56.1 years; tertiary International Prognosis Index (tIPI) observed at relapse was 0-2 in 71.6% of the patients and >2 in 28.4%. The overall response rate to third-line chemotherapy was 44%. The median overall survival (OS) was 10.0 months (median follow-up: 32.8 months). Thirteen patients received an allogeneic SCT, and three a second ASCT. The median OS was shorter among patients who relapsed <6 months (5.7 months) compared with those relapsing ⩾12 months after ASCT (12.6 months, P=0.0221). The median OS in patients achieving CR, PR or no response after the third-line regimen was 37.7 (P<0.0001), 10.0 (P=0.03) and 6.3 months, respectively. The median OS varied according to tIPI: 0-2: 12.6 months and >2: 5.3 months (P=0.0007). In multivariate analysis, tIPI >2, achievement of response and remission lasting <6 months predicted the OS. This report identifies the prognostic factors for DLBCL relapsing after ASCT and thus helps to select patients for experimental therapy.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>France</li><li>Royaume-Uni</li><li>République tchèque</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bohême centrale</li><li>Grand Londres</li><li>Grand Manchester</li><li>Hambourg</li><li>Provence-Alpes-Côte d'Azur</li><li>Région de Bruxelles-Capitale</li><li>État de New York</li><li>Île-de-France</li></region><settlement><li>Bruxelles</li><li>Hambourg</li><li>Londres</li><li>Manchester</li><li>Marseille</li><li>Nice</li><li>Paris</li><li>Prague</li></settlement><orgName><li>University College de Londres</li></orgName></list><tree><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Van Den Neste, E" sort="Van Den Neste, E" uniqKey="Van Den Neste E" first="E" last="Van Den Neste">E. Van Den Neste</name></region></country><country name="Allemagne"><region name="Hambourg"><name sortKey="Schmitz, N" sort="Schmitz, N" uniqKey="Schmitz N" first="N" last="Schmitz">N. Schmitz</name></region><name sortKey="Duhrsen, U" sort="Duhrsen, U" uniqKey="Duhrsen U" first="U" last="Dührsen">U. Dührsen</name><name sortKey="Glass, B" sort="Glass, B" uniqKey="Glass B" first="B" last="Glass">B. Glass</name></country><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Mounier, N" sort="Mounier, N" uniqKey="Mounier N" first="N" last="Mounier">N. Mounier</name></region><name sortKey="Bachy, E" sort="Bachy, E" uniqKey="Bachy E" first="E" last="Bachy">E. Bachy</name><name sortKey="Bouadballah, R" sort="Bouadballah, R" uniqKey="Bouadballah R" first="R" last="Bouadballah">R. Bouadballah</name><name sortKey="Briere, J" sort="Briere, J" uniqKey="Briere J" first="J" last="Briere">J. Briere</name><name sortKey="Gisselbrecht, C" sort="Gisselbrecht, C" uniqKey="Gisselbrecht C" first="C" last="Gisselbrecht">C. Gisselbrecht</name><name sortKey="Ribrag, V" sort="Ribrag, V" uniqKey="Ribrag V" first="V" last="Ribrag">V. Ribrag</name><name sortKey="Thieblemont, C" sort="Thieblemont, C" uniqKey="Thieblemont C" first="C" last="Thieblemont">C. Thieblemont</name></country><country name="Australie"><noRegion><name sortKey="Gill, D" sort="Gill, D" uniqKey="Gill D" first="D" last="Gill">D. Gill</name></noRegion><name sortKey="Ma, D" sort="Ma, D" uniqKey="Ma D" first="D" last="Ma">D. Ma</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Linch, D" sort="Linch, D" uniqKey="Linch D" first="D" last="Linch">D. Linch</name></region><name sortKey="Radford, J" sort="Radford, J" uniqKey="Radford J" first="J" last="Radford">J. Radford</name></country><country name="République tchèque"><region name="Bohême centrale"><name sortKey="Trneny, M" sort="Trneny, M" uniqKey="Trneny M" first="M" last="Trneny">M. Trneny</name></region></country><country name="Suisse"><noRegion><name sortKey="Bargetzi, M" sort="Bargetzi, M" uniqKey="Bargetzi M" first="M" last="Bargetzi">M. Bargetzi</name></noRegion></country><country name="États-Unis"><region name="État de New York"><name sortKey="Moskowitz, C H" sort="Moskowitz, C H" uniqKey="Moskowitz C" first="C H" last="Moskowitz">C H Moskowitz</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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