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- Title
Impact of Radiation Therapy After High Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation in Patients With Relapsed/Refractory Lymphomas: A Single Center Experience.
- Authors
Osmani, Asif Husain; Khafaga, Yasser; Rauf, Muhammad Shahzad; Maghfoor, Irfan; Akhtar, Saad
- Abstract
After high dose chemotherapy (HDC) and autologous stem cell transplantation (auto-SCT), in patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL) and Hodgkin lymphoma (HL), involved field radiation therapy (RT) for consolidation and residual/progressive disease (PD) eradication is a common practice. Retrospective single-institution cohort analysis to evaluate the impact of early RT after HDC auto-SCT. Between 1996 and October 2019, 153 patients (43 DLBCL, 110 HL) underwent RT after HDC auto-SCT. Males 95 (62%), females 58 (38%), median age 24 years. Indications for RT was consolidation 65%: residual disease eradication 16%: and PD eradication 19%. For DLBCL, the median overall survival (OS) for the above indications was not reached (NR):NR:2 months and the KM 5-year OS was 72.6%:64.3%:12.5% respectively (P ≤.000). Pair-wise analysis showed that consolidation versus residual disease eradication had no difference (P =.88) but both were superior to PD disease eradication (P ≤ 000 and P =.005 respectively). For HL, indication for RT was, 54%:23%:24% respectively. The median OS was NR:NR:28.8 months and KM 5-year OS was 82.3%:78%:30% respectively (P ≤.000). Pair-wise analysis showed that consolidation versus residual disease eradication had no difference (P =.98) but both were superior to the PD eradication group (P ≤ 000). RT was well tolerated with no significant long-term toxicity. Post HDC auto-SCT RT was well tolerated. DLBCL and HL patients with residual disease treated with the RT had similar long-term survival as those who received RT for consolidation. RT failed to improve the poor survival in patients with post-HDC auto-SCT PD. In this retrospective analysis of lymphomas patients (43 DLBCL, 110 HL), we evaluated the impact of post HDC auto-SCT IFRT. Patients with residual disease treated with the IFRT had similar survival as those who received IFRT for consolidation. IFRT failed to improve the poor survival in patients with progressive disease. No long term IFRT complication noted.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2022, Vol 22, Issue 3, pe149
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/j.clml.2021.09.003