Correlation of pretransplant and early post‐transplant response assessment with outcomes after reduced‐intensity allogeneic hematopoietic stem cell transplantation for non‐Hodgkin's lymphoma

BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non‐Hodgkin lymphoma (NHL) patients undergoing reduced‐intensity allogeneic hematopoietic stem cell transplantation (allo‐HCT). The authors hypothesized that fur...

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Veröffentlicht in:Cancer 2010-02, Vol.116 (4), p.852-862
Hauptverfasser: Bishop, Michael R., Dean, Robert M., Steinberg, Seth M., Odom, Jeanne, Pollack, Seth M., Pavletic, Steven Z., Sportes, Claude, Gress, Ronald E., Fowler, Daniel H.
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container_end_page 862
container_issue 4
container_start_page 852
container_title Cancer
container_volume 116
creator Bishop, Michael R.
Dean, Robert M.
Steinberg, Seth M.
Odom, Jeanne
Pollack, Seth M.
Pavletic, Steven Z.
Sportes, Claude
Gress, Ronald E.
Fowler, Daniel H.
description BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non‐Hodgkin lymphoma (NHL) patients undergoing reduced‐intensity allogeneic hematopoietic stem cell transplantation (allo‐HCT). The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post‐transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post‐transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced‐intensity allo‐HCT. RESULTS: The 3‐year event‐free survival (EFS) and overall survival (OS) (median potential follow‐up after reduced‐intensity allo‐HCT = 58 months) for all patients was 37% and 47%, respectively. The 3‐year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3‐year follow‐up. The 3‐year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3‐year EFS based on post‐transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post‐transplant reached 3‐year follow‐up. The 3‐year OS based on post‐transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P < .0001). Pretransplant response (P < .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reduced‐intensity allo‐HCT, and patients with pretransplant PD should only receive this therapy in clinical trials. Cancer 2010. © 2010 American Cancer Society. The specific disease response obtained with salvage chemotherapy for relapsed and refractory non‐Hodgkin lymphoma correlates with post‐transplant outcomes in patients being considered for reduced‐intensity allogeneic stem cell transplantation. The differentiation of chemotherapy sensitivity, based on specific responses to salvage chemotherapy, identifies specific patient populations that may or may not benefit from this procedure.
doi_str_mv 10.1002/cncr.24845
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The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post‐transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post‐transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced‐intensity allo‐HCT. RESULTS: The 3‐year event‐free survival (EFS) and overall survival (OS) (median potential follow‐up after reduced‐intensity allo‐HCT = 58 months) for all patients was 37% and 47%, respectively. The 3‐year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3‐year follow‐up. The 3‐year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3‐year EFS based on post‐transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post‐transplant reached 3‐year follow‐up. The 3‐year OS based on post‐transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P &lt; .0001). Pretransplant response (P &lt; .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reduced‐intensity allo‐HCT, and patients with pretransplant PD should only receive this therapy in clinical trials. Cancer 2010. © 2010 American Cancer Society. The specific disease response obtained with salvage chemotherapy for relapsed and refractory non‐Hodgkin lymphoma correlates with post‐transplant outcomes in patients being considered for reduced‐intensity allogeneic stem cell transplantation. The differentiation of chemotherapy sensitivity, based on specific responses to salvage chemotherapy, identifies specific patient populations that may or may not benefit from this procedure.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.24845</identifier><identifier>PMID: 20041482</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; chemotherapy sensitivity ; Clinical Trials as Topic ; Cyclophosphamide - therapeutic use ; Disease-Free Survival ; Doxorubicin - therapeutic use ; Etoposide - therapeutic use ; Female ; Hematologic and hematopoietic diseases ; hematopoietic stem cell transplantation ; Hematopoietic Stem Cell Transplantation - methods ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Lymphoma, Non-Hodgkin - mortality ; Lymphoma, Non-Hodgkin - surgery ; Male ; Medical sciences ; Middle Aged ; nonmyeloablative ; non‐Hodgkin lymphoma ; Postoperative Period ; Prednisone - therapeutic use ; Preoperative Period ; reduced‐intensity ; Survival Rate ; Transplantation Conditioning ; Transplantation, Autologous ; Treatment Outcome ; Tumors ; Vincristine - therapeutic use</subject><ispartof>Cancer, 2010-02, Vol.116 (4), p.852-862</ispartof><rights>Copyright © 2010 American Cancer Society</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4815-b5006da2e4c6712c921690fc7574536092f9a6c7d441bc4752a43bd876f2fc323</citedby><cites>FETCH-LOGICAL-c4815-b5006da2e4c6712c921690fc7574536092f9a6c7d441bc4752a43bd876f2fc323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.24845$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.24845$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=22397880$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20041482$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bishop, Michael R.</creatorcontrib><creatorcontrib>Dean, Robert M.</creatorcontrib><creatorcontrib>Steinberg, Seth M.</creatorcontrib><creatorcontrib>Odom, Jeanne</creatorcontrib><creatorcontrib>Pollack, Seth M.</creatorcontrib><creatorcontrib>Pavletic, Steven Z.</creatorcontrib><creatorcontrib>Sportes, Claude</creatorcontrib><creatorcontrib>Gress, Ronald E.</creatorcontrib><creatorcontrib>Fowler, Daniel H.</creatorcontrib><title>Correlation of pretransplant and early post‐transplant response assessment with outcomes after reduced‐intensity allogeneic hematopoietic stem cell transplantation for non‐Hodgkin's lymphoma</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non‐Hodgkin lymphoma (NHL) patients undergoing reduced‐intensity allogeneic hematopoietic stem cell transplantation (allo‐HCT). The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post‐transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post‐transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced‐intensity allo‐HCT. RESULTS: The 3‐year event‐free survival (EFS) and overall survival (OS) (median potential follow‐up after reduced‐intensity allo‐HCT = 58 months) for all patients was 37% and 47%, respectively. The 3‐year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3‐year follow‐up. The 3‐year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3‐year EFS based on post‐transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post‐transplant reached 3‐year follow‐up. The 3‐year OS based on post‐transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P &lt; .0001). Pretransplant response (P &lt; .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reduced‐intensity allo‐HCT, and patients with pretransplant PD should only receive this therapy in clinical trials. Cancer 2010. © 2010 American Cancer Society. The specific disease response obtained with salvage chemotherapy for relapsed and refractory non‐Hodgkin lymphoma correlates with post‐transplant outcomes in patients being considered for reduced‐intensity allogeneic stem cell transplantation. The differentiation of chemotherapy sensitivity, based on specific responses to salvage chemotherapy, identifies specific patient populations that may or may not benefit from this procedure.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>chemotherapy sensitivity</subject><subject>Clinical Trials as Topic</subject><subject>Cyclophosphamide - therapeutic use</subject><subject>Disease-Free Survival</subject><subject>Doxorubicin - therapeutic use</subject><subject>Etoposide - therapeutic use</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>hematopoietic stem cell transplantation</subject><subject>Hematopoietic Stem Cell Transplantation - methods</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Lymphoma, Non-Hodgkin - mortality</subject><subject>Lymphoma, Non-Hodgkin - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>nonmyeloablative</subject><subject>non‐Hodgkin lymphoma</subject><subject>Postoperative Period</subject><subject>Prednisone - therapeutic use</subject><subject>Preoperative Period</subject><subject>reduced‐intensity</subject><subject>Survival Rate</subject><subject>Transplantation Conditioning</subject><subject>Transplantation, Autologous</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Vincristine - therapeutic use</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc-KFDEQxoMo7jh68QEkF1kQZk3SSf-5CMugrrAoiIK3kElXz0TTSZvKuMzNR_ChfBKfxIwz7q4XT6FSv3xfVT5CHnN2xhkTz22w6UzIVqo7ZMZZ1ywYl-IumTHG2oWS1acT8gDxcykboar75EQwJrlsxYz8XMaUwJvsYqBxoFOCnEzAyZuQqQk9BZP8jk4R86_vP271EuAUAwI1iIA4Qrm7cnlD4zbbOAJSM2RIheu3Fvry2IUMAV3eUeN9XEMAZ-kGRpPjFB3kUmGGkVrwnt44HWYbYqIhhiJzEfv1FxdOkfrdOG3iaB6Se4PxCI-O55x8fPXyw_Jicfnu9Zvl-eXCyparxUoxVvdGgLR1w4XtBK87NthGNVJVNevE0JnaNr2UfGVlo4SR1apvm3oQg61ENScvDrrTdjVCb8vKyXg9JTeatNPROP1vJ7iNXsdvulat6Oq6CJweBVL8ugXMenS4X9cEiFvUjayZYqpMMyfPDqRNETHBcO3Cmd6nrvep6z-pF_jJ7bmu0b8xF-DpETBojR_K31qHN5youqZtWeH4gbtyHnb_sdTLt8v3B_Pf4H7PvQ</recordid><startdate>20100215</startdate><enddate>20100215</enddate><creator>Bishop, Michael R.</creator><creator>Dean, Robert M.</creator><creator>Steinberg, Seth M.</creator><creator>Odom, Jeanne</creator><creator>Pollack, Seth M.</creator><creator>Pavletic, Steven Z.</creator><creator>Sportes, Claude</creator><creator>Gress, Ronald E.</creator><creator>Fowler, Daniel H.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20100215</creationdate><title>Correlation of pretransplant and early post‐transplant response assessment with outcomes after reduced‐intensity allogeneic hematopoietic stem cell transplantation for non‐Hodgkin's lymphoma</title><author>Bishop, Michael R. ; Dean, Robert M. ; Steinberg, Seth M. ; Odom, Jeanne ; Pollack, Seth M. ; Pavletic, Steven Z. ; Sportes, Claude ; Gress, Ronald E. ; Fowler, Daniel H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4815-b5006da2e4c6712c921690fc7574536092f9a6c7d441bc4752a43bd876f2fc323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>chemotherapy sensitivity</topic><topic>Clinical Trials as Topic</topic><topic>Cyclophosphamide - therapeutic use</topic><topic>Disease-Free Survival</topic><topic>Doxorubicin - therapeutic use</topic><topic>Etoposide - therapeutic use</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>hematopoietic stem cell transplantation</topic><topic>Hematopoietic Stem Cell Transplantation - methods</topic><topic>Humans</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Lymphoma, Non-Hodgkin - mortality</topic><topic>Lymphoma, Non-Hodgkin - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>nonmyeloablative</topic><topic>non‐Hodgkin lymphoma</topic><topic>Postoperative Period</topic><topic>Prednisone - therapeutic use</topic><topic>Preoperative Period</topic><topic>reduced‐intensity</topic><topic>Survival Rate</topic><topic>Transplantation Conditioning</topic><topic>Transplantation, Autologous</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Vincristine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bishop, Michael R.</creatorcontrib><creatorcontrib>Dean, Robert M.</creatorcontrib><creatorcontrib>Steinberg, Seth M.</creatorcontrib><creatorcontrib>Odom, Jeanne</creatorcontrib><creatorcontrib>Pollack, Seth M.</creatorcontrib><creatorcontrib>Pavletic, Steven Z.</creatorcontrib><creatorcontrib>Sportes, Claude</creatorcontrib><creatorcontrib>Gress, Ronald E.</creatorcontrib><creatorcontrib>Fowler, Daniel H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bishop, Michael R.</au><au>Dean, Robert M.</au><au>Steinberg, Seth M.</au><au>Odom, Jeanne</au><au>Pollack, Seth M.</au><au>Pavletic, Steven Z.</au><au>Sportes, Claude</au><au>Gress, Ronald E.</au><au>Fowler, Daniel H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation of pretransplant and early post‐transplant response assessment with outcomes after reduced‐intensity allogeneic hematopoietic stem cell transplantation for non‐Hodgkin's lymphoma</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2010-02-15</date><risdate>2010</risdate><volume>116</volume><issue>4</issue><spage>852</spage><epage>862</epage><pages>852-862</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND: Chemotherapy sensitivity, defined simply as at least a partial response to chemotherapy, is an important outcome predictor for non‐Hodgkin lymphoma (NHL) patients undergoing reduced‐intensity allogeneic hematopoietic stem cell transplantation (allo‐HCT). The authors hypothesized that further differentiation of chemotherapy sensitivity by specific response, complete remission (CR) versus partial remission (PR) versus stable disease (SD) versus progression of disease (PD), correlates with post‐transplant outcomes. METHODS: The impact of pretransplant and early (28 days) post‐transplant disease response on transplant outcomes was analyzed in 63 NHL patients treated with reduced‐intensity allo‐HCT. RESULTS: The 3‐year event‐free survival (EFS) and overall survival (OS) (median potential follow‐up after reduced‐intensity allo‐HCT = 58 months) for all patients was 37% and 47%, respectively. The 3‐year EFS based on pretransplant response was: CR = 50%; PR = 66%; SD = 18%; no patient with PD pretransplant reached 3‐year follow‐up. The 3‐year OS based on pretransplant response was: CR = 63%; PR = 69%; SD = 45%. The 3‐year EFS based on post‐transplant response was: CR = 57%; PR = 32%; SD = 33%; no patient with PD post‐transplant reached 3‐year follow‐up. The 3‐year OS based on post‐transplant response was: CR = 65%; PR = 43%; SD = 50%. In multivariate analyses, pretransplant response was the best predictor of EFS (P &lt; .0001). Pretransplant response (P &lt; .0001) and age (P = .0035) were jointly associated with OS. CONCLUSIONS: These data suggest that NHL patients with pretransplant SD, generally considered inappropriate candidates, may benefit from reduced‐intensity allo‐HCT, and patients with pretransplant PD should only receive this therapy in clinical trials. Cancer 2010. © 2010 American Cancer Society. The specific disease response obtained with salvage chemotherapy for relapsed and refractory non‐Hodgkin lymphoma correlates with post‐transplant outcomes in patients being considered for reduced‐intensity allogeneic stem cell transplantation. The differentiation of chemotherapy sensitivity, based on specific responses to salvage chemotherapy, identifies specific patient populations that may or may not benefit from this procedure.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>20041482</pmid><doi>10.1002/cncr.24845</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
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source Wiley-Blackwell Journals; MEDLINE; Free E-Journal (出版社公開部分のみ); Wiley Online Library Free Content; Alma/SFX Local Collection
subjects Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
chemotherapy sensitivity
Clinical Trials as Topic
Cyclophosphamide - therapeutic use
Disease-Free Survival
Doxorubicin - therapeutic use
Etoposide - therapeutic use
Female
Hematologic and hematopoietic diseases
hematopoietic stem cell transplantation
Hematopoietic Stem Cell Transplantation - methods
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymphoma, Non-Hodgkin - mortality
Lymphoma, Non-Hodgkin - surgery
Male
Medical sciences
Middle Aged
nonmyeloablative
non‐Hodgkin lymphoma
Postoperative Period
Prednisone - therapeutic use
Preoperative Period
reduced‐intensity
Survival Rate
Transplantation Conditioning
Transplantation, Autologous
Treatment Outcome
Tumors
Vincristine - therapeutic use
title Correlation of pretransplant and early post‐transplant response assessment with outcomes after reduced‐intensity allogeneic hematopoietic stem cell transplantation for non‐Hodgkin's lymphoma
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