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The different roles of molecular classification according to upfront autologous stem cell transplantation in advanced-stage diffuse large B cell lymphoma patients with elevated serum lactate dehydrogenase

Authors
 Yu Ri Kim  ;  Soo-Jeong Kim  ;  June-Won Cheong  ;  Deok-Hwan Yang  ;  Hyewon Lee  ;  Hyeon-Seok Eom  ;  Yong Oh Sung  ;  Hyo Jung Kim  ;  Hye Jin Kang  ;  Won-Sik Lee  ;  Yong Park  ;  Woo-Ick Yang  ;  Yoo Hong Min  ;  Jin Seok Kim 
Citation
 Annals of Hematology, Vol.95(9) : 1491-1501, 2016 
Journal Title
 Annals of Hematology 
ISSN
 0939-5555 
Issue Date
2016
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation/methods* ; Humans ; Kaplan-Meier Estimate ; L-Lactate Dehydrogenase/blood ; L-Lactate Dehydrogenase/metabolism* ; Lymphoma, Large B-Cell, Diffuse/blood ; Lymphoma, Large B-Cell, Diffuse/classification ; Lymphoma, Large B-Cell, Diffuse/therapy* ; Male ; Middle Aged ; Neoplasm Staging ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/statistics & numerical data ; Proportional Hazards Models ; Remission Induction ; Retrospective Studies ; Transplantation, Autologous ; Young Adult
Keywords
Autologous hematopoietic stem cell transplantation ; Diffuse large B cell lymphoma ; Germinal center B cell ; Non-germinal center B cell ; Rituximab
Abstract
The non-germinal center B cell (non-GCB) subtype of diffuse large B cell lymphoma (DLBCL) is more related to poor prognosis than the GCB subtype. To investigate the role of molecular classification according to upfront autologous hematopoietic stem cell transplantation (ASCT), we retrospectively evaluated 219 newly diagnosed high-risk DLBCL patients. Eighty-one patients were in the ASCT group, and 138 patients were in the non-ASCT group. The ASCT group yielded significantly better overall survival (OS) and progression-free survival (PFS) than the non-ASCT group (p = 0.038 and p = 0.007), and patients with the non-GCB subtype were more related to inferior PFS than those with the GCB subtype (p = 0.020). After performing age-matching by using propensity scores, upfront ASCT continued to show better OS and PFS than non-ASCT (p = 0.046 and p = 0.026). In the non-ASCT group, the non-GCB subtype showed worse OS and PFS than the GCB subtype (p = 0.039 and p = 0.007). Patients who achieved complete response showed differences in OS and PFS according to molecular subtype (p = 0.007 and p = 0.002). In the ASCT group, there were no significant differences in OS and PFS according to molecular classification (p = 0.277 and p = 0.892). In conclusion, non-GCB subtype DLBCL patients showed poor OS and PFS in the non-ASCT group while they did not show clinical significance in the ASCT group. This suggests the possibility that upfront ASCT may improve the poor prognosis of non-GCB subtype in high-risk DLBCL.
Full Text
http://link.springer.com/article/10.1007%2Fs00277-016-2729-4
DOI
10.1007/s00277-016-2729-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151721
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