The non-relapse mortality rate for patients with diffuse large B-cell lymphoma is greater than relapse mortality 8years after autologous stem cell transplantation and is significantly higher than mortality rates of population controls

Brian T. Hill, Lisa Rybicki, Brian J. Bolwell, Stephen Smith, Robert Dean, Matt Kalaycio, Brad Pohlman, Shawnda Tench, Ronald Sobecks, Steven Andresen, Edward Copelan, John Sweetenham

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

High dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the preferred treatment modality for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). To assess long-term outcomes of these patients, we retrospectively analysed data from 309 consecutive patients who underwent ASCT for DLBCL between 1994 and 2006. We found that non-relapse mortality (NRM) became the major cause of death beginning approximately 8years after ASCT. The most common causes of NRM during the study period were respiratory failure (31%), infection (13%), cardiac toxicity (15%) and secondary malignancy (15%). The strongest predictor of relapse mortality (RM) was disease status at transplant: patients who were in second or greater complete or partial remission had a higher risk of RM than those in first complete or partial remission [hazard ratio (HR) 3·7, P<0·001], as did those who were relapsed or refractory (HR 4·9, P<0·001). We describe the longest reported follow-up of a large cohort of DLBCL patients uniformly-treated with ASCT. Although relapse was initially the more likely cause of death, NRM exceeded RM after 8years. After ASCT, surviving patients have significantly increased risk mortality rates relative to the general population and this excess risk persists over time.

Original languageEnglish (US)
Pages (from-to)561-569
Number of pages9
JournalBritish Journal of Haematology
Volume152
Issue number5
DOIs
StatePublished - Mar 2011

Keywords

  • Autologous stem cell transplantation
  • Diffuse large B cell lymphoma
  • Late effects
  • Treatment-related mortality

ASJC Scopus subject areas

  • Hematology

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