PRIMARY'REFRACTORY'DLBCL’S'RESULTS'AFTER'AUTOLOGOUS'STEM'CELL'
POSTER'41'
TRANSPLANTATION!
'
Ana!Carolina!Oliver,!Pablo!Muxi,!Eloisa!Riva,!Sebastian!Galeano,!Silvia!Pierri,!Ada!Caneiro,!Laura!Bello,!
Regis!Gai!and!Andrew!Miller!
!
Hospital!Británico,!Montevideo,!Uruguay!
!
Introduction:!Primary!refractory!Diffuse!Large!B!Cell!Lymphoma!(DLBCL)!occurs!in!10J15%!of!
patients!after!RJCHOP!treatment.!This!includes!patients!achieving!less!than!partial!remission!
(PR)! to! frontJline! therapy,! or! patients! progressing! within! 3J6! months! of! completion! of!
treatment.! In! this! population,! the! standard! of! care! is! Rituximab! associated! to! second! line!
chemotherapy!followed!by!Autologous!Stem!Cell!Transplantation!(ASCT)!in! chemosensitive!
patients.!There!are!few!publications!focused!in!the!results!of!specifically!primary!refractory!
DLBCL! in! Rituximab! era! therefore,! the! objective! of! this! retrospective! cohort! study! is! to!
evaluate! the! complete! response! (CR)! and! overall! survival! (OS)! of! this! population! and!
compare!them!with!patients!transplanted!when!the!relapse!occurs!after!6!months.!
Methods:! retrospective! study! of! all! consecutive! primary! refractory! DLBCL! that! received!
autologous! stem! cell! transplantation! after! second! line! chemotherapy! between! 2000! and!
2019.!
Results:! between! 2000J2019! we! performed! 68! ASCT! in! DLBCL.! Of! them:! 16! did! not! use!
Rituximab!as!first!line!and!5!were!transplanted!in!first!CR!after!RJCHOP!therefore,!they!were!
excluded.! The! study! population! is! composed! of! 45! patients:! 9! relapsed! after! 6! months!
(Relapsed! Group)! and! 35! were! primary! refractory:! 25! with! PR! after! RJCHOP,! 5! progressed!
and!5!relapsed!earlier!than!6!months.!Definition!of!response:!by!PET/CT:!25!patients!(58.1%),!
by!CT!20!patients!(41.9%).!Median!age:!55!years!(22J71),!51%!were!male,!71%!were!stage!IIIJ
IV.!Response!after!second!line!therapy:!of!the!primary!refractory:!12!(33%)!became!CR!and!
of!relapsed!group!6!(66%)!reached!CR.!With!a!median!follow!up!of!46!months!(1.8J239.2),!
the!3Jyear!OS!is!73%.!Primary!refractory!group!has!a!3Jyear!OS!of!66%!and!relapsed!group!
has!100%!(p=0.03).!The!OS!among!refractory!patient’s!subgroups!was!similar!p=0.7.!There!is!
no!difference!in!3Jyear!OS!between!patients!transplanted!in!CR!o!PR!(p=0.78)!however,!only!
25%!were!confirmed!by!PET/CT.!It’s!important!to!notice!that!22%!of!patients!in!PR!and!28%!
of!CR!had!PET/CT.!
Conclusions:!patients!transplanted!in!primary!refractory!disease!have!less!CR!and!poorer!OS!
compared!with!patients!that!have!a!later!relapse.!Even!though!this!is!a!retrospective!analysis!
and!a!little!cohort,!this!results!suggests!that!chemo!resistance!is!one!of!the!most!important!
factor! determining! OS! in! DLBCL.! Nevertheless,! at! least! 66%! of! patients! with! primary!
refractory!DLCBL!who!proceeds!to!ASCT!are!alive!at!3!years.!
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES