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  • 1
    ISSN: 1569-8041
    Keywords: autologous hemopoietic stem-cell transplantation ; diffuse large-cell lymphoma ; international prognostic index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Dose intensification and autologous stem cell transplantation as front-line therapy in non-Hodgkin's lymphoma patients (NHL) is a matter for debate, although preliminary data suggest a role for it in patients at high risk of resistance or relapse according to the international prognostic index (IPI). Purpose and study design: To compare retrospectively the clinical outcome of two cohorts of NHL patients with high-risk IPI treated with MACOP-B for 12 weeks (38 patients) or high-dose chemotherapy (44 patients) including eight weeks of MACOP-B, one or two intensification cycles with mitoxanthrone, dexamethasone, high-dose ara-C and finally BEAM chemotherapy with autologous hemopoietic progenitor cell transplantation. Results: The actuarial estimate of event (progression, relapse or death)-free survival (EFS) at three years was better (58% vs. 41%, P = 0.08) for patients treated with the intensive regimen even though the overall survival did not show a statistically significant difference (63% vs. 50%, P = 0.27). Multivariate analysis showed that the high-dose chemotherapy program was the only independent variable correlating with a reduction in the event rate. Conclusion: Early autologous stem-cell transplantation might improve the clinical outcome of high-risk patients according to IPI.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: combined-modality treatment ; DLCL ; PGL ; stage-modified IPI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The definition of prognostic parameters in early stages of gastric lymphoma is still controversial. The aim of this retrospective analysis was to assess the value of the stage-modified international prognostic index (IPI) in predicting the outcome of a large, consecutive series of patients with PGL of diffuse large B-cell histology (DLCL). Patients and methods: Three hundred twelve consecutive, newly-diagnosed, patients with localized PGL (stages I–IIE according to the ‘Lugano staging system for GI lymphomas’) referred from April 1972 to December 1997 to eight Italian and one Swiss centers were reviewed and their outcomes updated to June 1998. One hundred three patients were treated with single-modality therapy, while two hundred four received combined-modality treatment, most of which included surgery and short-term chemotherapy. Results: After a median follow-up of 66 months (range 0.6–300 months), 195 (64%) were alive in first continuous complete remission (CCR). The five-year estimates of overall survival (OS) and event-free survival (EFS) were 75% and 67%, respectively. OS and EFS varied according to IPI, from, respectively, 90% and 82% for patients with 0–1 risk factors, to 40% and 35% for patients with ≥3 risk factors (P = 0.00001). Cox regression analysis showed that IPI was the strongest predictor of survival. Conclusions: This study shows that stage-modified IPI is an effective predictive model in patients with primary DLCL of the stomach, enabling identification of patients with significantly different outcomes.
    Type of Medium: Electronic Resource
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