Non-Hodgkin’s Lymphoma: Five-year Survival in a Historical Cohort of Patients who Underwent Stem Cell Transplantation in Brazil

Resumo

Introduction: Several studies have shown the benefits of stem cell transplantation in the treatment of Non-Hodgkin’s lymphoma. Objective: To evaluate survival and associated factors in transplanted Non-Hodgkin’s lymphoma patients in Brazil. Method: We conducted a retrospective analysis of 100 adult patients with Non-Hodgkin’s lymphoma transplanted in a national reference center for hematopoietic stem cell transplantation between 1997 and 2009. Data was obtained from medical charts and included besides socio-demographic and lifestyle variables, others related to diagnosis and transplantation. The five-year survival probability was estimated using the Kaplan-Meier method and differences between curves were tested with the log-rank test, assuming statistical significance level of 5%. Cox regression was performed for multivariate analysis. Results: Median age at diagnosis was 43 years (17-65) and 45 years (18-66) at transplantation. Median time between diagnosis and transplantation was 17 months (4-173). The probability of survival at 5 years was 50.8% with a median survival time of 22.5 months. In multivariate analysis, evidence of disease 12 months after transplant (HR: 4.49; 95% CI 2.15-9.39), chemo-sensitivity to the last regimen before transplant (HR: 2.92; 95% CI 1.35-6.32) and advanced stage at diagnosis (HR: 1.96, 95% CI 1.02-3.80) were prognostic factors for survival. Conclusion: Median age at transplantation in this cohort was similar to that of other studies but median time between diagnosis and transplantation was higher. Although overall survival (5 years) approached that reported in other studies, different treatment protocols and specific characteristics of each population limit comparisons.