In the CORAL study, 255 chemosensitive relapses with diffuse large B-cell lymphoma (DLBCL) were consolidated with autologous stem cell transplantation (ASCT), and 75 of them relapsed thereafter. The median time between ASCT and progression was 7.1 months. The median age was 56.1 years; tertiary International Prognosis Index (tIPI) observed at relapse was 0-2 in 71.6% of the patients and >2 in 28.4%. The overall response rate to third-line chemotherapy was 44%. The median overall survival (OS) was 10.0 months (median follow-up: 32.8 months). Thirteen patients received an allogeneic SCT, and three a second ASCT. The median OS was shorter among patients who relapsed <6 months (5.7 months) compared with those relapsing ⩾12 months after ASCT (12.6 months, P=0.0221). The median OS in patients achieving CR, PR or no response after the third-line regimen was 37.7 (P<0.0001), 10.0 (P=0.03) and 6.3 months, respectively. The median OS varied according to tIPI: 0-2: 12.6 months and >2: 5.3 months (P=0.0007). In multivariate analysis, tIPI >2, achievement of response and remission lasting <6 months predicted the OS. This report identifies the prognostic factors for DLBCL relapsing after ASCT and thus helps to select patients for experimental therapy.

AsklepiosKlinik St Georg AbteilungHämatologie und Stammzelltransplantation Hamburg Germany

Charles University and General Hospital Praha Czech Republic

CHU de l'Archet route de St Antoine Ginestiere Nice France

Cliniques Universitaires UCL Saint Luc Brussels Belgium

Hämatologie Kantonsspital Aarau Aarau Switzerland

Hopital Saint Louis Paris Paris France

Hospices Civils de Lyon Université de Lyon Pierre Benite France

Institut Gustave Roussy Villejuif France

Institut Paoli Calmette Département d'Onco Hématologie Institut Paoli Calmettes Marseille France

Memorial Sloan Kettering Cancer Center New York NY USA

Princess Alexandra Hospital Woodville South Australia Australia

St Vincent's Hospital Sydney Darlinghurst NSW Australia

Universitätsklinikum Essen KlinikfürHämatologie Hufelandstraße Essen Germany

University College London Cancer Institute London UK

University of Manchester and the Christie NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK

Bone Marrow Transplant. 2017 Feb;52(2):199-200. doi: 10.1038/bmt.2016.292. PubMed

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