Dean Erin A, Lin Rick Y, Lin Tuo, Li Derek M, Hsu Jack W, Hiemenz John W, Lynch James W, Wingard John R
Department of Medicine Division of Hematology and Oncology University of Florida Gainesville Florida USA.
Department of Medicine University of Florida Gainesville Florida USA.
EJHaem. 2025 Jul 24;6(4):e70108. doi: 10.1002/jha2.70108. eCollection 2025 Aug.
To ensure response is preserved, it is common practice to continue chemotherapy in patients with large B-cell lymphoma (LBCL) awaiting autologous hematopoietic stem cell transplant (HSCT), even after they have achieved complete or partial response (CR/PR).
We conducted a retrospective chart review of patients with LBCL evaluated at our institution between 2011 and 2022 to examine the effect of delay of transplant and continuation of chemotherapy past CR/PR on progression of disease (PD) prior to transplant. The association of PD prior to transplant with delayed transplant and additional chemotherapy was modeled using logistic regression.
Out of the 87 patients included, 74 (85%) had relapsed/refractory LBCL. Transplant was delayed in 20 (23%) patients, and 22 (25%) patients received chemotherapy after CR/PR. Delay of transplant was associated with higher odds of PD prior to transplant (odds ratio [OR] = 4.0, = 0.034), as was additional chemotherapy use after CR/PR (OR = 2.2, = 0.09).
Proceeding to autologous HSCT as soon as adequate response is achieved in LBLC was associated with a lower likelihood of progression of disease prior to transplant regardless of additional chemotherapy receipt.
The authors have confirmed that clinical trial registration is not needed for this submission.
为确保疗效得以维持，对于等待自体造血干细胞移植（HSCT）的大B细胞淋巴瘤（LBCL）患者，即便已达到完全缓解或部分缓解（CR/PR），继续进行化疗仍是常见的做法。
我们对2011年至2022年在本机构接受评估的LBCL患者进行了回顾性病历审查，以研究移植延迟以及在达到CR/PR后继续化疗对移植前疾病进展（PD）的影响。使用逻辑回归对移植前的PD与移植延迟和额外化疗之间的关联进行建模。
在纳入的87例患者中，74例（85%）为复发/难治性LBCL。20例（23%）患者的移植被延迟，22例（25%）患者在达到CR/PR后接受了化疗。移植延迟与移植前更高的PD几率相关（优势比[OR]=4.0，P=0.034），在达到CR/PR后使用额外化疗也是如此（OR=2.2，P=0.09）。
在LBLC患者一旦获得充分缓解就尽快进行自体HSCT，与移植前较低的疾病进展可能性相关，无论是否接受额外化疗。
作者已确认本研究无需进行临床试验注册。
