We retrospectively investigated the safety and effectiveness of HDT/ASCT in patients with untreated DLBCL. Twenty-two patients, aged 60 years and younger, with untreated DLBCL (classified as high-intermediate [n?=?14 (64 % )] or high [n?=?8 (32 % )] risk) underwent upfront HDT/ASCT between January 2004 and December 2008, achieving either a complete response (CR; n?= 15 (68 % )) or a partial response (PR; n?= 7 (32 % )).
The 5-year overall survival rate was 81.0 % and the progression-free survival rate was 73.0 % , with no significant difference between risk groups based on the international prognostic index. The most common nonhematologic toxicity was febrile neutropenia [n?=?9 (41 % )]. The cause of all 3 fatalities was exacerbation of the underlying disease, and no treatment-related mortality was observed. No variables with a significant influence on overall survival were identified, but a correlation of the treatment response before transplanation with progression-free survival was suggested (CR vs. PR: 92 % vs. 30 % , P?= .002).
These results suggest that adding rituximab to upfront HDT/ASCT is feasible and can improve the outcome in untreated patients with poor-prognosis DLBCL. In the future, upfront HDT/ASCT should be more extensively evaluated in clinical trials.