Lerner, R.E., et al. - This study aimed to determine whether the International Prognostic Index (IPI) assessed at time of relapse (IPI-R) could be used to identify patients with greater probability for long-term survival following autologous hematopoietic stem cell transplantation (auto HSCT). Methodology
80 patients with diffuse large cell lymphoma in either second complete remission (CR 2, n=27) or partial remission (PR 2, n=53) were treated with auto HSCT.
Clinical features predictive of overall survival (OS) and progression-free survival (PFS) were analyzed.
Results
Post-auto HSCT, CR was achieved in 73 patients (91%).
OS and PFS at 5 years were 38% and 32%, respectively.
IPI-R identified 2 risk groups with significantly different OS and PFS.
The high-risk group (3, 4, or 5 IPI factors) had 2.0 times the risk of death and 2.2 times the risk of relapse as the low-risk group (0, 1, or 2 IPI factors).
The median OS was 5 months versus 27 months and the median PFS was 2 months versus 8 months for the high- and low-risk IPI-R groups, respectively.
High-risk IPI-R status and bone marrow (BM) involvement at diagnosis were independent predictors for poor OS and PFS.
Results suggest that IPI-R predicts OS and PFS following auto HSCT for patients with aggressive NHL in CR 2 or PR 2.
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