Characteristics associated with long-term progression-free survival following @entity2101 in XXXX and influence of chemotherapy dose.

@entity1 @entity172 @entity0 @entity5 @entity2101
BACKGROUND: The purpose of this study was to characterize long-term progression-free survivors (LTPFS) of @entity0 ( @entity0 ) following @entity2101 ( @entity2101 ) with autologous stem cell transplantation (ASCT) and to assess the influence of chemotherapy dose in order to identify @entity1 who derive major benefit from this approach. @entity1 AND METHODS: We compared @entity1 and @entity5 characteristics of 16 LTPFS with the characteristics of 118 @entity0 @entity1 who received @entity2101 with ASCT at our institution between 1992 and 2000. To estimate the cumulative dose of chemotherapy received, the summation dose intensity product (SDIP) of the different chemotherapy regimens was calculated as recently described by Hryniuk et al. The SDIP of the induction regimens was added to that of the @entity2101 regimens to yield the total SDIP of the chemotherapy received. Multivariate analysis was performed to describe the influence of the total SDIP and other prognostic factors on progression-free survival (PFS). RESULTS: LTPFS were mostly < or = 50 years of age and had limited, chemotherapy-sensitive, hormone-responsive @entity0 . Due to an apparent dose-survival relationship, an increase by 10 units (U) in the SDIP increased the PFS time by 3 months. Independent predictors of an improved PFS were positive @entity172 receptors (P = 0.001), positive combined hormone receptors (P = 0.020), and a complete remission/no evidence of disease status after @entity2101 (P < 0.001). In @entity1 who had a disease-free interval (DFI) >24 months after primary surgery, an SDIP of >55 U was independently associated with a longer PFS [hazard ratio (HR) = 2.73; 95% confidence interval 1.29-5.81; P = 0.009]. CONCLUSION: @entity2101 can achieve long-term PFS in young @entity0 @entity1 with limited, hormone-responsive and chemotherapy-sensitive disease. After a DFI >24 months, a longer PFS is associated with a higher chemotherapy dose as measured by SDIP. These retrospective analyses suggest SDIP might be a tool for studying cumulative dose as a determinant of outcome of @entity0 chemotherapy. Thus far, however, we cannot clearly identify any subgroup of @entity0 @entity1 in whom @entity2101 with ASCT is of particular benefit.
