Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India
PURPOSEPublished experience with autologous stem-cell transplantation (ASCT) in non-Hodgkin lymphoma (NHL) from the Indian subcontinent is extremely limited. Here, we describe the activity and outcomes of this treatment modality at a large tertiary care center in India.PATIENTS AND METHODSWe retrosp...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2022-05-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.21.00383 |
| _version_ | 1811247791539748864 |
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| author | Sudhir Kumar Atul Sharma Raja Pramanik Neha Pathak Ajay Gogia Akash Kumar Smita Kayal Vinod Sharma Ranjit Kumar Sahoo Sanjay Thulkar M.C. Sharma Ritu Gupta Soumya Mallick Mercy Thomas Vinod Raina |
| author_facet | Sudhir Kumar Atul Sharma Raja Pramanik Neha Pathak Ajay Gogia Akash Kumar Smita Kayal Vinod Sharma Ranjit Kumar Sahoo Sanjay Thulkar M.C. Sharma Ritu Gupta Soumya Mallick Mercy Thomas Vinod Raina |
| author_sort | Sudhir Kumar |
| collection | DOAJ |
| description | PURPOSEPublished experience with autologous stem-cell transplantation (ASCT) in non-Hodgkin lymphoma (NHL) from the Indian subcontinent is extremely limited. Here, we describe the activity and outcomes of this treatment modality at a large tertiary care center in India.PATIENTS AND METHODSWe retrospectively analyzed adult patients with NHL who were eligible for ASCT and autografted between January 1, 2002, and December 15, 2020, at our transplant unit. Toxicities, complications, and long-term outcomes were compared between patients who underwent transplant during 2002-2012 (group A) and 2013-2020 (group B).RESULTSOverall, 80 patients (group A, n = 37; group B, n = 43) underwent ASCT using peripheral blood stem cells. At a median follow-up of 57.6 months, the 5-year event-free survival (EFS) and overall survival (OS) were 43.5% and 47.6%, respectively, for all patients. More recently (group B), patients had reduced 100-day transplant-related mortality (2.3% v 21.6%, P < .01), improved 3-year EFS (52.9% v 37.3%, P = .04), and superior OS (at 3-year; 63.4% v 43.2%, P = .02). Patients in group B also tolerated the procedure better, with improved resource utilization. In multivariate analysis, an International Prognostic Index (IPI) ≥ 3 at diagnosis adversely affected EFS (hazard ratio [HR] = 2.82, P = .009) and OS (HR = 2.84, P = .01) after ASCT. Low pretransplant serum albumin levels were associated with inferior EFS (HR = 2.68, P = .02) and transplant-related mortality (odds ratio = 10.80, P = .02) after ASCT.CONCLUSIONIt is feasible to achieve comparable short- and long-term outcomes in patients with NHL undergoing ASCT in a resource-poor country with improved supportive care and expertise of the transplant team and center. |
| first_indexed | 2024-04-12T15:15:41Z |
| format | Article |
| id | doaj.art-d8441be773b346f79704b6579045b867 |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-04-12T15:15:41Z |
| publishDate | 2022-05-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-d8441be773b346f79704b6579045b8672022-12-22T03:27:37ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412022-05-01810.1200/GO.21.00383Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in IndiaSudhir Kumar0Atul Sharma1Raja Pramanik2Neha Pathak3Ajay Gogia4Akash Kumar5Smita Kayal6Vinod Sharma7Ranjit Kumar Sahoo8Sanjay Thulkar9M.C. Sharma10Ritu Gupta11Soumya Mallick12Mercy Thomas13Vinod Raina14Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Radio Diagnosis, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Lab Oncology Unit, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, IndiaFortis Memorial Research Institute, Gurgaon, IndiaPURPOSEPublished experience with autologous stem-cell transplantation (ASCT) in non-Hodgkin lymphoma (NHL) from the Indian subcontinent is extremely limited. Here, we describe the activity and outcomes of this treatment modality at a large tertiary care center in India.PATIENTS AND METHODSWe retrospectively analyzed adult patients with NHL who were eligible for ASCT and autografted between January 1, 2002, and December 15, 2020, at our transplant unit. Toxicities, complications, and long-term outcomes were compared between patients who underwent transplant during 2002-2012 (group A) and 2013-2020 (group B).RESULTSOverall, 80 patients (group A, n = 37; group B, n = 43) underwent ASCT using peripheral blood stem cells. At a median follow-up of 57.6 months, the 5-year event-free survival (EFS) and overall survival (OS) were 43.5% and 47.6%, respectively, for all patients. More recently (group B), patients had reduced 100-day transplant-related mortality (2.3% v 21.6%, P < .01), improved 3-year EFS (52.9% v 37.3%, P = .04), and superior OS (at 3-year; 63.4% v 43.2%, P = .02). Patients in group B also tolerated the procedure better, with improved resource utilization. In multivariate analysis, an International Prognostic Index (IPI) ≥ 3 at diagnosis adversely affected EFS (hazard ratio [HR] = 2.82, P = .009) and OS (HR = 2.84, P = .01) after ASCT. Low pretransplant serum albumin levels were associated with inferior EFS (HR = 2.68, P = .02) and transplant-related mortality (odds ratio = 10.80, P = .02) after ASCT.CONCLUSIONIt is feasible to achieve comparable short- and long-term outcomes in patients with NHL undergoing ASCT in a resource-poor country with improved supportive care and expertise of the transplant team and center.https://ascopubs.org/doi/10.1200/GO.21.00383 |
| spellingShingle | Sudhir Kumar Atul Sharma Raja Pramanik Neha Pathak Ajay Gogia Akash Kumar Smita Kayal Vinod Sharma Ranjit Kumar Sahoo Sanjay Thulkar M.C. Sharma Ritu Gupta Soumya Mallick Mercy Thomas Vinod Raina Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India JCO Global Oncology |
| title | Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India |
| title_full | Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India |
| title_fullStr | Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India |
| title_full_unstemmed | Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India |
| title_short | Long-Term Outcomes and Safety Trends of Autologous Stem-Cell Transplantation in Non-Hodgkin Lymphoma: A Report From A Tertiary Care Center in India |
| title_sort | long term outcomes and safety trends of autologous stem cell transplantation in non hodgkin lymphoma a report from a tertiary care center in india |
| url | https://ascopubs.org/doi/10.1200/GO.21.00383 |
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