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  • Title: LACE-conditioned autologous stem cell transplantation for relapsed or refractory diffuse large B-cell lymphoma: treatment outcome and risk factor analysis from a single centre.
    Author: Pavlů J, Auner HW, Ellis S, Szydlo RM, Giles C, Contento A, Rahemtulla A, Apperley JF, Naresh K, MacDonald DH, Kanfer EJ.
    Journal: Hematol Oncol; 2011 Jun; 29(2):75-80. PubMed ID: 20635327.
    Abstract:
    High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a recognized treatment option for patients with relapsed diffuse large B-cell lymphoma. We have analysed 51 patients who underwent ASCT after LACE (lomustine (CCNU), cytarabine (Ara-C), cyclophosphamide, etoposide) conditioning for relapsed (n = 34, 67%) or primary refractory (n = 17, 33%) diffuse large B-cell lymphoma. With a median follow-up of 60 months (range 2-216) the probabilities of overall survival (OS) and progression-free survival (PFS) at 5 years were 47 and 42%, respectively. The cumulative treatment-related mortality was 10% (n = 5). Probabilities for OS and PFS at 5 years were 56 and 50% for patients with chemosensitive and 29 and 27% for patients with chemorefractory disease. In multivariate analysis abnormal pre-ASCT levels of C-reactive protein (>5 mg/L) were identified as a risk factor for worse OS, whereas abnormal pre-ASCT levels of C-reactive protein and chemoresistance predicted inferior PFS. LACE followed by ASCT is an effective treatment for approximately half of patients with chemosensitive relapsed diffuse large B-cell lymphoma, and a proportion of chemorefractory patients also benefit.
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