Can the Autologous Transplant of Hematopoyetic Progenitors be Considered an Effective Alternative to Increase Global Survival in High-Grade Non-Hodgkin Lymphomas?

BACKGROUND: Diffuse large B-cell non-Hodgkin's lymphoma (NHL) is the most common High Grade Lymphoma obtaining complete responses up to 70% with chemotherapy (R-CHOP) ¹. Transplantation has been implemented as an alternative, however in this lymphoma There have been few benefits compared to other treatments. ²

Transplantation of hematopoietic progenitors is a complex and costly process requiring infrastructure, specialized personnel as well as specialized laboratory medication and support⁸. However, in our country, both the infrastructure and the economic resources of the health services are limited, so that the management and selection strategies of patients eligible for transplantation should be more rigorous. At present, we do not have a study in our country that exemplifies what studies such as the PARMA and CORAL have shown, in which the lack of effectiveness of this transplant in the LDCBG has been shown ^3,4.

OBJETIVE: To evaluate the overall survival of patients with high-grade NHL in treatment with R-CHOP with and without autologous transplantation of hematopoietic progenitors.

MATERIAL AND METHODS: Retrospective, longitudinal, observational study of patients with high-grade lymphoma who received AHPC against those who did not receive it, previously all received R-CHOP treatment. Data obtained through a transplant census of Specialties Medical Unit No. 25, Monterrey, Nuevo León Mexico, we used central tendency and dispersion tests as well as Kaplan Meier curves, considering a significant p ≤ 0.05. SPSS software13.0

Determining the survival time of each group, comparing both means and proportions and the time before relapse. Follow-up within a time period of 1 to 9 years.

RESULTS: 65 patients with diffuse large B-cell NHL were collected in the 2003-2015 period. We evaluated the effect of autologous transplantation vs transplant recipients; mean age 49.9 ± 13.9 years with highest proportion of men versus women 52.31% vs 47.69%. Comparing SLE and SG, OR for gender variable and Cox regression for more relevant variables.

CONCLUSION: When comparing the SLE and SG curves between the group that was transplant and the one that did not receive it, we did not find a statistically significant difference. It is not possible to state that autologous transplantation substantially modifies the prognosis of patients with diffuse large B-cell NHL. The results are consistent with those previously reported in other studies^5,6,13-15 . New prospective, multicenter, and larger sample size studies are planned to more accurately determine the efficacy and safety of AHPC as part of treatment Large B-cell NHL.