TitleResponse to second-line therapy defines the potential for cure in patients with recurrent diffuse large B-cell lymphoma: implications for the development of novel therapeutic strategies.
Publication TypeJournal Article
Year of Publication2010
AuthorsElstrom, Rebecca L., Martin Peter, Ostrow Katya, Barrientos Jacqueline, Chadburn Amy, Furman Richard, Ruan Jia, Shore Tsiporah, Schuster Michael, Cerchietti Leandro, Melnick Ari, Coleman Morton, and Leonard John P.
JournalClin Lymphoma Myeloma Leuk
Date Published2010 Jun
KeywordsAdult, Aged, Antineoplastic Combined Chemotherapy Protocols, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Salvage Therapy, Stem Cell Transplantation, Treatment Outcome, Young Adult

<p><b>BACKGROUND: </b>Patients with diffuse large B-cell lymphoma (DLBCL) who are not cured by initial therapy sometimes experience disease-free survival after autologous stem cell transplantation. Chemotherapy responsiveness before transplantation is a major predictor of outcome. Patients not responding to second-line regimens may receive third-line therapy in the hopes of achieving response, but outcome data are limited.</p><p><b>PATIENTS AND METHODS: </b>We identified patients with relapsed or refractory DLBCL at Weill Cornell Medical Center for whom data on responses to second-line chemotherapy were available.</p><p><b>RESULTS: </b>A total of 74 patients with relapsed or refractory DLBCL who underwent second-line chemotherapy between 1996 and 2007 were identified. Of these patients, 27 (36%) did not respond. The median overall survival of nonresponding patients was 4 months, and only 1 patient (4%) survived for 1 year. The choice of third-line aggressive chemotherapy instead of less intensive approaches did not confer a survival benefit.</p><p><b>CONCLUSION: </b>Our data demonstrate that patients with recurrent DLBCL not responding to second-line chemotherapy demonstrate dismal outcomes. Trials of novel regimens should be prioritized as management strategies for these patients. Our data provide an important benchmark in the evaluation of the potential clinical value of such approaches.</p>

Alternate JournalClin Lymphoma Myeloma Leuk
PubMed ID20511164