|
|
 Previous Article | Table of Contents | Next Article 
Blood, Vol. 95 No. 12 (June 15), 2000:
pp. 3687-3692
Quality of life-adjusted survival analysis of high-dose therapy
with autologous bone marrow transplantation versus sequential
chemotherapy for patients with aggressive lymphoma in first
complete remission
Nicolas Mounier,
Corinne Haioun,
Bernard F. Cole,
Christian Gisselbrecht,
Catherine Sebban,
Pierre Morel,
Gerald Marit,
Reda Bouabdallah,
Christophe Ravoet,
Gilles Salles,
Felix Reyes, and
Eric Lepage for the
Groupe d'Etude des Lymphomes de l'Adulte (GELA)
From the Département d'information hospitalier and Service
d'hématologie clinique Hôpital Henri Mondor, AP-HP,
Créteil, France; Dartmouth-Hitchcock Medical Center, Lebanon, NH;
Institut d'hématologie, Hôpital Saint Louis, AP-HP, Paris,
France; Service d'hématologie, Centre Léon Bérard,
Lyon, France; Service d'hématologie, Centre Hospitalier du Dr
Schaffner, Lens, France; Service d'hématologie, CHU de Bordeaux,
Pessac, France; Service d'hématologie, Institut Paoli Calmette,
Marseille, France; Service d'hématologie, Centre Jolimont, La
Louvière, Belgium; and Service d'hématologie, Centre
Hospitalier Lyon Sud, Pierre Bénite, France.
Evaluating high-dose therapy (HDT) with autologous stem cell
transplantation (ASCT) in term of both duration and quality of life
(QOL) presents major interests for patients with non-Hodgkin lymphoma.
The quality-adjusted time without symptom and toxicity (Q-TWiST)
methodology was applied to the LNH87-2 trial comparing HDT with ASCT
versus sequential chemotherapy in 541 patients in first complete
remission (CR). Overall survival (OS) and disease-free survival (DFS)
curves were used to estimate duration of 4 health states: acute
short-term toxicity (Tox1), secondary toxicity (Tox2), time without
symptom and toxicity (TWiST), and relapse (Rel). Areas under survival
curves (AUC) were retrospectively weighted according to QOL
coefficients. HDT increased, but not significantly, TWiST (+2.4
months in AUC, P = .17) and decreased Rel ( 3 months, P < .01). Survival estimates did not differ between the 2 treatments (AUC 47.7 months for OS, 39.7 months for DFS). High-risk
patients treated by HDT versus chemotherapy had a significant benefit
in DFS (AUC 28.8 versus 24.9 months, P < .01) but not in OS
(AUC 37.3 versus 36 months, P = .27). Sensitivity analysis,
performed by varying QOL coefficients, demonstrated significant
quality-adjusted survival gain in high-risk patients treated by HDT. In
low-risk patients, a diagram provided an aid to clinical
decision-making. This analysis supports the use of HDT in these
patients with adverse prognostic factors in the first CR, even after
adjusting for QOL using the Q-TWiST method.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
D. C. Seldin, J. J. Anderson, V. Sanchorawala, K. Malek, D. G. Wright, K. Quillen, K. T. Finn, J. L. Berk, L. M. Dember, R. H. Falk, et al.
Improvement in quality of life of patients with AL amyloidosis treated with high-dose melphalan and autologous stem cell transplantation
Blood,
September 15, 2004;
104(6):
1888 - 1893.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Mounier, C. Ferme, H. Flechtner, M. M. Henry-Amar, and E. Lepage
Model-Based Methodology for Analyzing Incomplete Quality-of-Life Data and Integrating Them into the Q-Twist Framework
Med Decis Making,
January 1, 2003;
23(1):
54 - 66.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Ladetto, P. Corradini, S. Vallet, F. Benedetti, U. Vitolo, M. Martelli, M. Brugiatelli, P. Coser, A. Perrotti, I. Majolino, et al.
High rate of clinical and molecular remissions in follicular lymphoma patients receiving high-dose sequential chemotherapy and autografting at diagnosis: a multicenter, prospective study by the Gruppo Italiano Trapianto Midollo Osseo (GITMO)
Blood,
August 13, 2002;
100(5):
1559 - 1565.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Gisselbrecht, E. Lepage, T. Molina, B. Quesnel, G. Fillet, P. Lederlin, B. Coiffier, H. Tilly, J. Gabarre, F. Guilmin, et al.
Shortened First-Line High-Dose Chemotherapy for Patients With Poor-Prognosis Aggressive Lymphoma
J. Clin. Oncol.,
May 15, 2002;
20(10):
2472 - 2479.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Hensel, G. Egerer, A. Schneeweiss, H. Goldschmidt, and A. D. Ho
Quality of life and rehabilitation in social and professional life after autologous stem cell transplantation
Ann. Onc.,
February 20, 2002;
13(2):
209 - 217.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Strother, D. Ashley, S. J. Kellie, A. Patel, D. Jones-Wallace, S. Thompson, R. Heideman, E. Benaim, R. Krance, L. Bowman, et al.
Feasibility of Four Consecutive High-Dose Chemotherapy Cycles With Stem-Cell Rescue for Patients With Newly Diagnosed Medulloblastoma or Supratentorial Primitive Neuroectodermal Tumor After Craniospinal Radiotherapy: Results of a Collaborative Study
J. Clin. Oncol.,
May 15, 2001;
19(10):
2696 - 2704.
[Abstract]
[Full Text]
[PDF]
|
|
|
| |
