High-dose therapy and autologous stem cell transplant for transformed non-Hodgkin lymphoma in the rituximab era

Abstract

The impact of rituximab on the outcome of high-dose therapy and autologous stem cell transplant (HD-ASCT) for transformed non-Hodgkin lymphoma (NHL) has not been previously described. We analyzed 18 consecutive patients with indolent NHL who transformed to diffuse large B-cell lymphoma (DLBCL), received rituximab-containing therapy either before or after transformation and underwent subsequent HD-ASCT. With a median follow-up of 40 months, the 2-year progression-free survival (PFS) was 59% and the 2-year overall survival (OS) was 82%. Six patients did not receive rituximab pre-transformation. This group had a significantly better PFS at 2 years post-HD-ASCT compared to 12 patients who were exposed to rituximab pre-transformation (p = 0.03). HD-ASCT remains an effective therapeutic option for transformed NHL in the rituximab era. However, patients exposed to rituximab pre-transformation appear to have inferior HD-ASCT outcomes, and thus may benefit from novel conditioning and maintenance regimens in the setting of HD-ASCT.

Keywords::

• HD-ASCT
• transformed NHL
• rituximab
• transplant

Acknowledgements

Research support was obtained from the University of Rochester SPORE in lymphoma, CA 130805 (to Drs. Friedberg, Bernstein and Kelly).

We are indebted to the nurses, social workers, nurse practitioners and technicians of the University of Rochester Medical Center's Wilmot Cancer Center. We also thank Lisa McNiece for administrative assistance in preparation of the manuscript.

Potential conflict of interest:

There are no conflicts of interest to report. Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.