Efficacy
A summary of the evidence supporting the effect of this protocol is below:
In a single centre study of 67 HL patients with a median follow-up of 67 months, overall survival (OS) was 68% at 5 years and 60% at 10 years.r Progression-free survival (PFS) was 64% and 51% at 5 and 10 years, respectively. Mixed cellularity or lymphocyte-depleted histology subtype and haemoglobin of less than or equal to 10 g/dL at the time of ASCT predicted for worse OS. Stage III/IV disease at diagnosis and disease status other than complete or partial remission (CR, PR) at transplant predicted inferior PFS.
For DLBCL, OS and PFS at 5 years were 47% and 42% respectively in 51 patients with relapsed or refractory disease.r Chemo-refractory disease at time of ASCT predicted for poorer PFS.
© Bone Marrow Transplant 2007
© Hematological Oncology 2011
These outcomes are consistent with those reported by Gupta et al.r for HL and NHL subgroups respectively. Khattry et al.,r however, report lower OS and disease-free survival (DFS) with no difference observed between HL and NHL.
Study |
No. of
Patients
|
NRM/TRM |
Response* |
Relapse Rate |
OS (1yr/2yr) |
DFS |
Comments |
Perz et al.r |
67 |
D100: 3% |
Mixed cellularity, lymphocyte-depleted and Hb <10g/dL at time of ASCT predict for worse OS
|
Not reported |
5 year: 68%
10 year: 60%
|
5 year: 64%
10 year: 51%
|
Median follow up of 67 months
Cumulative incidence of second malignancy 3.8% and 17% at 5 and 10 years
|
Pavlu et al.r |
51 |
D100: 8% |
Chemorefractory disease at ASCT predicted for poorer PFS. Elevated CRP associated with worse OS and PFS |
Not reported |
5 year: 47% |
5 year: 42% |
Median follow up of 60 months |
Khattry et al.r |
75 |
D100: 9% |
Not reported |
Not reported |
5 year: 46% |
5 year: 37% |
Median follow up of 4.1 years
Higher CD34 cell count and greater proportion in CR at time of transplant in LACE group compared with BEAM
|
Gupta et al.r |
100 |
D100: 7% |
HD: IPS >2 at relapse predicted for poorer OS in multivariable analysis, p<0.001 |
Not reported |
3 year: 70%
HD subgroup
3 year:78%
NHL subgroup
3 year:51%
|
3 year: 58%
HD subgroup
3 year:62%
NHL subgroup
3 year:46%
|
Median follow up of 3 years |
* OR = overall response; CR= complete response; PR=partial response; SD = stable disease; VGPR = very good partial response; R = refractory; NRM = non-relapse mortality; TRM = treatment-related mortality; OS = overall survival; DFS = disease-free survival; CRP = c-reactive protein; IPS = international ]rognostic score