Upfront autologous hematopoietic stem cell transplantation for high-risk patients with double-expressor diffuse large B cell lymphoma

Yu Ri Kim, Sun Och Yoon, Soo Jeong Kim, June Won Cheong, Haerim Chung, Jung Yeon Lee, Ji Eun Jang, Yundeok Kim, Woo Ick Yang, Yoo Hong Min, Jin Seok Kim

Research output: Contribution to journalArticle

Abstract

Although MYC and BCL2 co-expression in diffuse large B cell lymphoma (DLBCL) is associated with inferior prognosis, it remains uncertain whether upfront autologous hematopoietic stem cell transplantation (ASCT) is beneficial in this lymphoma. This study aimed to investigate whether ASCT consolidation could have a positive role for patients with MYC and BCL2 co-expression (double-expressor lymphoma, DEL). We retrospectively evaluated 67 DLBCL patients who underwent upfront ASCT following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy. The 5-year overall survival (OS) and progression-free survival (PFS) were 82.3% and 79.2%, respectively. There were 23 (34.3%) patients with DEL and 51 (76.1%) patients with non-germinal center B cell (GCB) subtype. The 5-year OS and PFS of patients with DEL were not different from those with non-DEL (P = 0.429 and P = 0.614, respectively). No survival difference for OS and PFS was also observed between GCB and non-GCB subtypes (P = 0.950 and P = 0.901, respectively). The OS and PFS were comparable for patients with DEL and non-DEL and both GCB and non-GCB subtypes. In conclusion, MYC and BCL2 co-expression did not have a poor prognostic impact among high-risk patients with DLBCL treated with upfront ASCT regardless of molecular classification. This preliminary study suggested that the role of consolidative ASCT is needed to be evaluated in a prospective randomized clinical trial.

Original languageEnglish
Pages (from-to)2149-2157
Number of pages9
JournalAnnals of Hematology
Volume99
Issue number9
DOIs
Publication statusPublished - 2020 Sep 1

All Science Journal Classification (ASJC) codes

  • Hematology

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    Kim, Y. R., Yoon, S. O., Kim, S. J., Cheong, J. W., Chung, H., Lee, J. Y., Jang, J. E., Kim, Y., Yang, W. I., Min, Y. H., & Kim, J. S. (2020). Upfront autologous hematopoietic stem cell transplantation for high-risk patients with double-expressor diffuse large B cell lymphoma. Annals of Hematology, 99(9), 2149-2157. https://doi.org/10.1007/s00277-020-04043-0