Objective: To evaluate the strategy of using high-dose etoposide mobilization followed by autologous peripheral blood stem cell transplantation (APBSCT) in patients with diffuse large B-cell lymphoma (DLBCL) refractory to Rituximab-based chemotherapy.
Methods: Forty patients with refractory DLBCL were treated with high-dose etoposide for stem cell mobilization. All patients were in progressive disease (PD) prior to mobilization, and underwent high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (APBSCT).
Results: Successful PBSC mobilization was achieved in all patients. Twenty-three patients (57.5%) showed clinical response to high-dose etoposide. After APBSCT, 17 patients (42.5%) achieved CR. The 2-year progression-free (PFS) and overall survival (OS) rate were higher in patients responded to high dose etoposide (64.1% and 77.7%) compared to those without response (11.8% and 11.8%; P<0.001 for both). The response to high dose etoposide mobilization therapy was an independent prognostic factor for CR achievement, PFS and OS after APBSCT.
Conclusion: High-dose etoposide mobilization chemotherapy followed by APBSCT could rescue a proportion of patients with refractory diffuse large B-cell lymphoma who responded to etoposide mobilization regimen.
No relevant conflicts of interest to declare.
Asterisk with author names denotes non-ASH members.