To investigate the use of high-dose therapy and autologous stem cell transplantation (ASCT) for relapsed or high-risk diffuse large B-cell lymphoma (DLBCL) between 1990 and 2007, we conducted a nationwide survey using the registry database of the Japan Society for Hematopoietic Cell Transplantation. Of the 1222 patients in the database, 576 (47%) received ASCT in first complete remission (CR1), 140 (12%) in first partial remission, 281 (23%) in sensitive relapse, 150 (12%) in resistant or sensitivity-unknown relapse, and 75 (6%) in primary refractory status. With a median follow-up of 22 months, the 2-year overall survival (OS) and progression-free survival rates were 71% and 68%, respectively. The cumulative incidences of 2-year non-relapse mortality and relapse/progression were 6% and 26%, respectively. Relapse/progression after ASCT in the rituximab era (2002-2007) was significantly lower than that in the pre-rituximab era (1990-2001; P < 0.001). Older age, male gender, poor performance status at ASCT, non-CR1 at ASCT, ASCT performed in 1990-2001, and LEED or MCEC regimen were adverse predictors of OS. Because ASCT for newly diagnosed high-risk DLBCL has not been performed recently, a registry database study to assess the impact of ASCT for relapsed or refractory DLBCL in the rituximab era is warranted.

中文翻译：

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大剂量治疗和自体干细胞移植治疗复发性或高风险弥漫性大B细胞淋巴瘤：一项全国性调查。

为了研究1990年至2007年之间大剂量治疗和自体干细胞移植（ASCT）在复发或高风险弥漫性大B细胞淋巴瘤（DLBCL）中的应用，我们使用了日本学会的注册数据库进行了全国范围的调查用于造血细胞移植。数据库中的1222例患者中，初次完全缓解（CR1）的576例（47％），初次部分缓解的140例（12％），敏感性复发281例（23％），耐药或150例（12％）接受了ASCT敏感性未知复发，原发性难治状态为75（6％）。中位随访期为22个月，其2年总生存率（OS）和无进展生存率分别为71％和68％。2年非复发死亡率和复发/进展的累积发生率分别为6％和26％。利妥昔单抗时代（2002-2007年）发生ASCT后的复发/进展显着低于利妥昔单抗前时代（1990-2001年； P <0.001）。年龄大，男性，ASCT的表现不佳，ASCT的非CR1、1990-2001年进行的ASCT以及LEED或MCEC方案是OS的不良预测指标。由于最近尚未进行针对新诊断的高危DLBCL的ASCT，因此有必要进行注册表数据库研究以评估ASCT对利妥昔单抗时代复发或难治性DLBCL的影响。