Autologous hematopoietic stem cell transplantation as first-line consolidation therapy can improve the prognosis of diffuse large B-cell lymphoma with high expression of MYC protein

Kaohsiung J Med Sci. 2019 Jul;35(7):425-431. doi: 10.1002/kjm2.12079. Epub 2019 May 2.

Abstract

Myc-positive diffuse large B-cell lymphoma has lower curative efficacy and long-term survival than its negative counterpart, even when treated with R-CHOP regimen. The present study aims to determine whether the use of autologous hematopoietic stem cell transplantation as a consolidation therapy can improve the curative efficacy in this type of patients after achieving the best effect of chemotherapy for the first time. The data of 50 patients with Myc-positive diffuse large B-cell lymphoma were retrospectively analyzed. Autologous transplantation was performed for 23 patients, while transplantation was not performed for 27 patients. The clinicopathological features and survival conditions were compared. The 1-year and 3-year progression-free survival (PFS) rates were 66.7% ± 0.9% and 57.7% ± 1.0%, respectively, in the non transplantation group, and 100% and 82.1% ± 0.1%, respectively, in the transplantation group (P = .021). The 1-year overall survival (OS) rate for these two groups was 88.7% ± 0.6% vs 100%, respectively, while the 3-year OS rates for these two groups was 78.6% ± 0.1% vs 91.3% ± 0.1%, respectively (P = .176). Hematopoietic stem cell transplantation performed after chemotherapy is a risk factor for OS. Autologous hematopoietic stem cell transplantation as a consolidation therapy in the early stage can improve the prognosis of patients with Myc-positive diffuse large B-cell lymphoma.

Keywords: autologous transplantation; c-Myc; difuse large B-cell lymphoma; lymphoma; outcome.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Consolidation Chemotherapy / methods*
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large B-Cell, Diffuse / therapy*
  • Male
  • Middle Aged
  • Prednisone / therapeutic use
  • Prognosis
  • Progression-Free Survival
  • Retrospective Studies
  • Transplantation, Autologous
  • Vincristine / therapeutic use

Substances

  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone