| Resum: |
We performed a retrospective multicenter study including 791 patients with relapsed/ refractory (R/R) large B-cell lymphoma (LBCL) who underwent autologous stem cell transplantation (ASCT). After a median follow-up of 74 months from infusion, 65% were alive and 84% free of disease. Progression-free survival (PFS) and overall survival (OS) at 6 years were 51% and 63%, respectively. Non-relapse mortality at 1 year was 9%. Age >60 years at ASCT (hazard ratio [HR], 1. 31; 95% CI, 1. 06-1. 62; P =. 011), ASCT as ≥3 line (HR, 1. 81; 95% CI, 1. 42-2. 31; P <. 001), and partial response (PR) vs complete response (CR) at ASCT (HR, 1. 46; 95% CI. 1. 18-1. 81; P <. 001) were independent variables influencing PFS. Age >60 years at ASCT (HR, 1. 62; 95% CI, 1. 24-2. 12; P <. 001), time period before 1 November 2012 (HR, 1. 40; 95% CI, 1. 07-1. 83; P =. 014), ASCT as ≥3 line (HR, 1. 77; 95% CI, 1. 32-2. 37; P <. 001), PR vs CR (HR, 1. 58; 95% CI, 1. 22-2. 05; P <. 001), and stable disease vs CR pre-ASCT (HR, 3. 41; 95% CI, 1. 81-6. 45; P <. 001) were variables associated with worse OS. Refractory/early relapse did not significantly influence survival (6-year PFS and OS in patients with refractory, early, and late relapse were 54% and 64%, 46% and 62%, and 49% and 63%, respectively). To our knowledge, this is the largest series analyzing the efficacy of ASCT in patients with R/R LBCL after rituximab-containing frontline therapy. Our results indicate that ASCT is a curative option for patients with chemosensitive disease. |