Vol. 69 No. 3 (2023), ORIGINAL ARTICLES. C. CLINICAL RESEARCH

Vol. 69 No. 3 (2023)

The Effect of high-dose chemotherapy with upfront autologous hematopoietic stem cell transplantation on the prognosis of patients with stage IV diffuse large B-cell lymphoma.

ORIGINAL ARTICLES. C. CLINICAL RESEARCH

https://doi.org/10.37469/0507-3758-2023-69-3-497-507

Published 30.06.2023

Aleksei Koviazin⁺⁻
Larisa Filatova⁺⁻
Ilia Zyuzgin⁺⁻
Anna Artemyeva⁺⁻
Ilia Poliatskin⁺⁻
Leonid Kramynin⁺⁻
Tatiana Semiglazova⁺⁻

Aleksei Koviazin

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation

https://orcid.org/0000-0001-5091-3711

Larisa Filatova

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation

https://orcid.org/0000-0002-0728-4582

Ilia Zyuzgin

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation

Anna Artemyeva

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation

Ilia Poliatskin

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation

Leonid Kramynin

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation

https://orcid.org/0000-0002-0728-4582

Tatiana Semiglazova

NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Saint-Petersburg, Russian Federation; North-Western State Medical University named after I.I.Mechnikov, Saint-Petersburg, Russian Federation

https://orcid.org/0000-0002-4305-6691

pdf (Русский)

Keywords

diffuse large B-cell lymphoma
stage IV
high-risk
autologous hematopoietic stem cell transplantation

How to Cite

Koviazin, A., Filatova, L., Zyuzgin, I., Artemyeva, A., Poliatskin, I., Kramynin, L., & Semiglazova, T. (2023). The Effect of high-dose chemotherapy with upfront autologous hematopoietic stem cell transplantation on the prognosis of patients with stage IV diffuse large B-cell lymphoma. Voprosy Onkologii, 69(3), 497–507. https://doi.org/10.37469/0507-3758-2023-69-3-497-507

Abstract

Background: Improving the effectiveness of first-line therapy for diffuse large B-cell lymphoma (DLBCL), especially at high risk, remains an urgent clinical task of oncohematology. The benefit of using high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HDCT with auto-HSCT) in first-line DLBCL in order to reduce the risk of recurrence and improve prognosis has not been determined and is relevant for clinical trials.

Aims: To study the impact on prognosis in IV stage DLBCL given by the upfront auto-HSCT.

Materials and methods: A group of 105 patients: DLBCL NOS, age 18-65, stage IV, IPI≥2, CR/PR after x6 R-CHOP/ R-DA-EPOCH from 2010 to 2019 at NMRC of Oncology named after N.N. Petrov of MoH of Russia was retrospectively analyzed. The HSCT group included patients with upfront HDCT followed by auto-HSCT (n = 35). The control group included patients with follow-up after induction (n = 70). Primary endpoints were 1-year and 3-year progression-free survival (PFS). Secondary endpoint was 3-year overall survival (OS)

Results: Upfront HDCT followed by auto-HSCT demonstrated significant advantage in 3-yr PFS (р = 0,029) and OS (р = 0,047). This impact on 3-year PFS (р <0,001) and OS (р <0,001) was stronger in DEL subgroup. In the HSCT group, the presence of DEL didn’t affect the 1-yr (р = 0,44), 3-yr PFS (р = 0,17) and OS (р = 0,34).

Conclusion: Upfront HDCT followed by auto-HSCT has a positive effect on prognosis in stage IV DLBCL patients, especially in DEL subgroup. The negative impact of DEL is leveled out by upfront HDCT followed by auto-HSCT.

https://doi.org/10.37469/0507-3758-2023-69-3-497-507

pdf (Русский)

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