Autologous stem-cell transplantation as consolidation therapy for diffuse large B-cell lymphoma patients with overexpression of bcl-2 protein. Results of the Groupe d'Etude des Lymphomes de l'Adulte (GELA) trial LNH98-B2.

Morel, P;Gaulard, P;Gisselbrecht, C;Ferme, C;Groupe d'Etude des Lymphomes de l'Adulte;et.al.
(2008) Annals of oncology : official journal of the European Society for Medical Oncology — Vol. 19, n° 3, p. 560-565 (2008)

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Authors
  • Morel, P
    Author
  • Gaulard, P
    Author
  • Gisselbrecht, C
    Author
  • Ferme, C
    Author
  • Théate, IvanUCLouvain
    Author
  • Groupe d'Etude des Lymphomes de l'Adulte
    Collaborator
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Abstract
Overexpression of B-cell lymphoma 2 (bcl-2) protein is a simple biological adverse prognostic factor that could delimit the poor prognosis population candidate for improvement with high-dose therapy and autologous stem-cell transplantation (ASCT) in diffuse large B-cell lymphoma (DLBCL). Therefore, we conducted a risk-adapted phase II study with ASCT as consolidation therapy in low-intermediate risk (LIR) International Prognostic Index patients aged < or = 60 years with bcl-2 overexpression (bcl-2+). Induction chemotherapy consisted of four courses of adriamycin, cyclophosphamide, vindesine, bleomycin, prednisone, once every 2 weeks. Responding bcl-2+ patients received ASCT as consolidation, and those without bcl-2 overexpression (bcl-2-) conventional chemotherapy. Three hundred and sixteen LIR patients with DLBCL, aged between 18 and 60 years, were included. Of these, 177 (56%) were bcl-2+ and 139 (44%) bcl-2-. Complete response rates after induction chemotherapy were similar in bcl-2+ and bcl-2- patients (74% versus 78%). Estimated 2-year event-free survival and disease-free survival for the bcl-2+ subgroup were 79% and 87%, for bcl-2- 84% and 92% and for the whole series 81% and 90%, respectively. These results demonstrate that taking into account biological characteristics in prospective multicenter trials allow successful adjustment of treatment and indicate that ASCT may counteract the adverse prognostic value of bcl-2 overexpression in responding LIR patients.
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Morel, P., Gaulard, P., Gisselbrecht, C., Ferme, C., Salles, G., Tilly, H., Brière, J., Copin, M. C., Lederlin, P., Hermine, O., Théate, I., Haioun, C., & Mounier, N. (2008). Autologous stem-cell transplantation as consolidation therapy for diffuse large B-cell lymphoma patients with overexpression of bcl-2 protein. Results of the Groupe d’Etude des Lymphomes de l’Adulte (GELA) trial LNH98-B2. Annals of oncology : official journal of the European Society for Medical Oncology, 19(3), 560-565. https://doi.org/10.1093/annonc/mdm520 (Original work published 2008)