Outcome of patients with transformed indolentnon-Hodgkin lymphoma referred for autologousstem-cell transplantation

Abstract

Background: The proportion of potentially eligible patients with transformed indolent non-Hodgkin lymphoma who undergo autologous stem-cell transplantation (ASCT) is unknown. There are limited data describing their outcome in the rituximab era. Patients and methods: We reviewed 105 consecutive patients with biopsy-proven transformation referred toPrincess Margaret Hospital for consideration of ASCT during 1996-2009. Patients received anthracycline or platinumbasedchemotherapy with or without rituximab. Responders proceeded to stem-cell mobilization and ASCT. Results: The median age at transformation was 54 (range 30-65) years. Patients received a median of twochemotherapy regimens for transformation, including rituximab in 39%. Fifty patients (48%) proceeded with ASCT and55 (52%) did not, mainly due to progressive disease (n = 42). Three-year overall (OS) and progression-free survival (PFS)post-ASCT were 54% and 42%, respectively. Patients receiving rituximab with chemotherapy before transplant had a3-year post-ASCT OS of 71% versus 47% in those who received chemotherapy alone (P = 0.046). Patientstransplanted after 2004 had a 3-year post-ASCT OS of 69% versus 39% in those receiving ASCT earlier (P = 0.009). Conclusions: About half of transplant-eligible patients with transformation are able to undergo ASCT. Outcomesfollowing ASCT appear to have improved over recent years, although the role of rituximab in this patient populationrequires further evaluation.© The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.