The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma Journal Article

  

Authors:	Moskowitz, C. H.; Nimer, S. D.; Glassman, J. R.; Portlock, C. S.; Yahalom, J.; Straus, D. J.; O'Brien, J. P.; Elkin, N.; Bertino, J. R.; Zelenetz, A. D.
Article Title:	The International Prognostic Index predicts for outcome following autologous stem cell transplantation in patients with relapsed and primary refractory intermediate-grade lymphoma
Abstract:	We analyzed a group of 51 patients with primary refractory and relapsed intermediate-grade lymphoma (IGL) from the time of initiation of three cycles of second-line chemotherapy, ifosfamide, carboplatin and etoposide (ICE), in whom the intent was to administer curative high-dose chemoradiotherapy and autologous stem cell transplantation (ASCT). We sought to determine if the International Prognostic Index (IPI) assessed immediately prior to ICE, second-line IPI (sIPI), was predictive of outcome. The response rate to ICE-based chemotherapy was 69%, and 47% of the transplanted patients remain failure-free at 2.5 years. Stratification of patients based upon the sIPI demonstrated a superior 2.5 year failure-free survival (FFS) curve for patients with low (I) or low-intermediate (II) risk disease vs those with high-intermediate (III) and high (IV) risk disease (45% vs 9%, P < 0.001). When the analysis was restricted to those patients with chemosensitive disease, the sIPI (I/II vs III/IV) also separated patients into two distinct prognostic groups (59% vs 20%, P = 0.04). Patients with sIPI I and II disease have a favorable outcome with ICE chemotherapy and ASCT. However, patients with sIPI III and IV disease derive limited benefit from this treatment strategy, and new approaches are needed in this patient group.
Keywords:	adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; middle aged; survival analysis; major clinical study; cancer recurrence; cisplatin; cancer radiotherapy; combined modality therapy; cytarabine; methotrexate; carboplatin; etoposide; antineoplastic combined chemotherapy protocols; stem cell transplantation; hematopoietic stem cell transplantation; ifosfamide; survival time; lymphoma; granulocyte colony stimulating factor; international prognostic index; autotransplantation; humans; prognosis; human; priority journal; article; asct; intermediate-grade lymphoma; lymphoma, intermediate-grade
Journal Title:	Bone Marrow Transplantation
Volume:	23
Issue:	6
ISSN:	0268-3369
Publisher:	Nature Publishing Group
Date Published:	1999-03-01
Start Page:	561
End Page:	567
Language:	English
PUBMED:	10217186
PROVIDER:	scopus
DOI:	10.1038/sj.bmt.1701624
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0032984816&partnerID=40&md5=d5e5a83e39e1d3570fa832f311a92083
Notes:	Article -- Export Date: 16 August 2016 -- Source: Scopus

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