Autologous stem cell transplantation for primary XXXX : results and clinical variables affecting outcome.

@entity1 @entity72460 @entity2033 @entity978 @entity1349
BACKGROUND: @entity1 with primary @entity978 (PR- @entity2033 ) have a dismal prognosis when treated with conventional salvage chemotherapy. We analyzed time to treatment failure (TTF), @entity1349 ( @entity1349 ) and clinical variables influencing the outcome in @entity1 undergoing autologous stem cell transplantation (ASCT) for PR- @entity2033 and reported to the Grupo Espa  ol de Linfomas/Trasplante Aut  logo de M  dula Osea (GEL/ @entity72460 ). @entity1 AND METHODS: Sixty-two @entity1 , 41 males and 21 females with a median age of 27 years (range 13-55) were analyzed. Forty-two @entity1 (68%) had advanced stage at diagnosis, 47 (76%) presented with B symptoms and 29 (47%) with a bulky mediastinal mass. Seventy-five percent of the @entity1 had received more than one line of therapy before ASCT. Thirty-three @entity1 received bone marrow as a source of hematopoietic progenitors, and 29 peripheral blood. Six @entity1 were conditioned with high-dose chemotherapy plus total-body irradiation and 56 received chemotherapy-based protocols. RESULTS: One-year transplantation-related mortality was 14% [95% confidence interval (CI) 6% to 23%]. Response rate at 3 months after ASCT was 52% [complete remission in 21 @entity1 (34%), partial remission in 11 @entity1 (18%)]. Actuarial 5-year TTF and @entity1349 were 15% (95% CI 5% to 24%) and 26% (95% CI 13% to 39%), respectively. The presence of B symptoms at ASCT was the only adverse prognostic factor significantly influencing TTF [relative risk (RR) 1.75, 95% CI 0.92-3.35, P = 0.08]. The presence of B symptoms at diagnosis (RR 2.08, 95% CI 0.90-4.79, P = 0.08), MOPP-like regimens as first-line therapy (RR 3.84, 95% CI 1.69-9.09, P = 0.001), bulky disease at ASCT (RR 2.79, 95% CI 0.29-6.03, P = 0.009) and two or more lines of therapy before ASCT (RR 2.24, 95% CI 0.95-5.27, P = 0.06) adversely influenced @entity1349 . CONCLUSIONS: In our experience, although overall results of ASCT in PR- @entity2033 @entity1 are poor, one-quarter of the @entity1 remain alive at 5 years. Despite this, other therapeutic strategies should be investigated in this group of @entity1 to improve the outcome.
