In a nutshell
The study analyzed outcomes of high-dose therapy (HDT) with autologous hematopoietic stem cell transplantation (AHSCT) for patients with non-Hodgkin lymphoma (NHL) in a resource-limited country and evaluated whether upfront AHSCT could be an effective treatment. The authors found promising outcomes of this treatment in a resource-limited country.
AHSCT uses patients’ own healthy stem cells to replace cancerous cells that were destroyed by previous therapy. Chemotherapy or radiotherapy is used before AHSCT to destroy cancer calls. HDT (higher than normal doses of chemotherapy), followed by AHSCT is widely used for patients whose NHL has relapsed or failed to respond to other treatments. However, reports on this therapy are based on developed countries only and data are lacking from South East Asia. Upfront AHSCT is now considered for patients with poor chances of being cured in selected countries. Identifying whether it could be feasible for patients with limited resources is necessary.
Methods & findings
The authors looked back in time to gather records of 148 patients with NHL who underwent HDT followed by AHSCT. 88.5% of patients were in complete remission (CR) before receiving AHSCT and 47% of them were in their first CR (CR1). CR defines the absence of all cancer symptoms after therapy. Patients were followed up for an average of 179.5 weeks (approximately 3.5 years) after AHSCT.
Overall, 68.9% of patients survived for 3 years on average. Event-free survival (EFS) for 3 years was 60.8%. EFS is how long patients survive without disease progression, relapse, or death. Overall survival (OS) for 3-years was 82.9% for receiving AHSCT in CR1, 65.6% in CR2, and 25% during partial remission (PR). PR defines partial disappearance of cancer symptoms.
Patients with lymphoma cells in their bone marrow had a 3-year OS of 51.7% compared to 73.7% for those without bone marrow involvement.
The bottom line
The study concluded that the outcomes of HDT followed by AHSCT for patients with NHL are promising in a resource-limited country.
The fine print
This study was based on medical records. Information from medical records could have been missing.
Published By :
International journal of clinical practice
Nov 17, 2020
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