Aim To retrospectively report the clinical outcomes of non‐Hodgkin's Lymphoma (NHL) patients post high dose therapy (HDT) with autologous haematopoietic stem cell transplant (AHSCT) and determine whether upfront transplant, which is a first‐line consolidative treatment with induction chemotherapy, would be a feasible modality in a resource‐limited country. Methods The medical records for NHL patients who had undergone HDT followed by AHSCT from October 1997 to November 2016 from two hospitals in Klang Valley, Malaysia were obtained from the medical record database and analysed retrospectively through statistical analysis. Results A total of 148 patients were retrospectively identified post‐AHSCT, where the majority of whom had B cell lymphoma (53.4%). Majority of patients (88.5%) were in complete remission before AHSCT. The overall survival (OS) and event‐free survival (EFS) at 3 years were 68.9% and 60.8%, respectively. The major cause of death was disease progression at 73.9%, while transplant‐related mortality was 15.2%, with a median follow‐up period of 179.5 weeks. Conclusion Our study illustrates the promising outcomes of HDT with AHSCT in NHL patients in a resource‐limited country. We recommend larger studies to be conducted in the future with a longer duration of follow‐up to validate our findings.
There is scarce information available in regards to the survival outcome of non-Hodgkin lymphoma (NHL) in South East Asia regions. Reports on the outcome of High dose therapy followed by autologous haematopoietic stem cell transplantation (AHSCT) were mainly from developed countries. In this study, we present the outcome of NHL patients treated with AHSCT from year 1997 to 2016 in two urban hospitals in Malaysia. A total of 140 patients were identified, majority of whom had B cell lymphoma (54.3%). Majority of patients (89.3%) were in complete remission at AHSCT. The overall survival (OS) and event-free survival (EFS) at 3 years were 70.7% and 62.1% respectively. The transplant-related mortality was 3.4%.
DA-EPOCH-R were registered in the Observational Epidemiological and Clinical Study registry NIHIL (govTrial no: NCT03199066). Basic characteristics are summarized in Table 1. The clinical outcomes of DA-EPOCH-R cohort were compared to 117 pts treated with R-CHOP regimen from 2 centres where intensification approach is not introduced. We performed 1:1 matched-pair analysis including these criteria: aaIPI, age and performance status.Results: Median age was 56 years (range: 20-70). Median number of administered DA-EPOCH-R cycles was 6 (range, 1-6). Dose escalation to 3 rd dose level or above was feasible in 68% pts. The overall response/complete remissions were achieved in 92%/78% pts. At a median follow up of 2.3 years, the median overall survival (OS) and progression-free survival (PFS) had not been reached; estimated 3-year PFS and OS were 70% and 85%, respectively.Predictors of short PFS in univariate analysis were the presence of B symptoms (p=0.006) and increased beta-2-microglobulin level (p=0.034). Serious (CTCAE grade III/IV) infections occurred in 21.6% of pts. 11% pts developed other serious non-hematologic toxicity. No significant differences in PFS and OS were observed between DA-EPOCH-R vs. R-CHOP in the matched-pair analysis ( Fig. 1). Estimated 3-year PFS and OS of pts treated with R-CHOP were 66% and 70%, respectively. Conclusion:The DA-EPOCH-R is an active and feasible treatment for high risk DLBCL pts. According to our data, DA-EPOCH-R did not improve PFS or OS compared to standard R-CHOP treatment.Aims: This study aims to determine if upfront AHSCT do improve patients' clinical outcome.Methods: This is a retrospective study where patients who had undergone AHSCT from October 1997 to September 2017 in 2 hospitals in Malaysia were included. Patients' demographic data and clinical information were collected. The risk groups were categorized into 2 groups via the International Prognostic Index (IPI); whereby IPI score of 0-2 were defined as low risk and IPI score of 3-5 were considered as high risk.Results: A total of 148 patients (male: female 92:56) were included. Majority of patients had B cell lymphoma (85.1%). The median age at diagnosis was 46 (ranges from 15 -69) years. The median period of diagnosis to AHSCT was 9.5 (range 2-112) months. Majority of patients (88.5%) were transplanted in complete remission (CR) and the remaining (11.5%) in partial remission (PR). 68% of patients were categorized as low risk and 32% patients were categorized as high risk. The transplant related mortality (TRM) was 3.4%. The overall survival (OS) and event free survival (EFS) at 3 years were 70.1% and 62.6% respectively. Patients who were transplanted in first CR had significantly better OS and EFS, p value of <0.0001. The TRM of 3.4% is similar to what was reported in other centres internationally. Summary/Conclusion: The significantly better clinical outcome of patients transplanted in first CR may suggest that upfront AHSCT is feasible and may improve outcomes. However, further studies would be required to co...
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