Daniel J. Landsburg, MD
For patients with double-hit lymphoma (DHL) who go into remission, there is no uniform procedure to prolong benefit. Autologous stem-cell transplant is performed on some patients to reduce the risk of relapse, but the impact has yet to be proven.
Landsburg, assistant professor, University of Pennsylvania School of Medicine, discussed the management of patients with DHL who have achieved remission.
OncLive: Please provide an overview of this study.
DHL is a very aggressive variant of non-Hodgkin lymphoma for which the outcomes of patients treated for this disease may be poor. Even with patients who go into remission, there are some who think doing an autologous stem cell transplant after patients achieved remission would be a strategy to reduce the risk of relapse. And in this disease, for the most part, relapses are fatal—it is particularly hard to control this disease once patients have relapsed. So, the thought was, even in remission, maybe they would benefit from a stem cell transplant, which would treat occult disease and put these patients into a longer-lasting remission. This was a clinical dilemma in patients that I have seen with this disease who had achieved a remission.
The background for the study is essentially, some of us would recommend doing a stem cell transplant in remission for these patients and some would not—so nobody really knew if there was a right answer. So, together, as a group of investigators, we tried to look at our outcomes of patients who had achieved a remission with DHL and then looked at their long-term outcomes based on whether they had received a stem cell transplant in first remission.
What were the significant results?
Essentially, we had 159 patients and about 40% had a transplant in first remission and 60% did not. When you look at their survival long-term, about 3 years later, overall survival and progression-free survival outcomes were not significantly different in the group that underwent the stem cell transplant versus those that did not. So, it was a negative study.
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