Outcome of patients with relapsed diffuse large B-cell lymphoma who fail second-line salvage regimens in the International CORAL study

E Van Den Neste, N Schmitz, N Mounier, D Gill, D Linch, M Trneny, N Milpied, J Radford, N Ketterer, O Shpilberg, U Dührsen, D Ma, J Brière, C Thieblemont, G Salles, C H Moskowitz, B Glass, C Gisselbrecht

Research output: Contribution to journalArticlepeer-review


Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard second-line treatment for relapsed and refractory diffuse large B-cell lymphoma (DLBCL). However, the strategy is less clear in patients who require third-line treatment. Updated outcomes of 203 patients who could not proceed to scheduled ASCT in the Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) are herein reviewed. In the intent-to-treat analysis, overall response rate to third-line chemotherapy was 39%, with 27% CR or CR unconfirmed, and 12% PR. Among the 203 patients, 64 (31.5%) were eventually transplanted (ASCT 56, allogeneic SCT 8). Median overall survival (OS) of the entire population was 4.4 months. OS was significantly improved in patients with lower tertiary International Prognostic Index (IPI), patients responding to third-line treatment and patients transplanted with a 1-year OS of 41.6% compared with 16.3% for the not transplanted (P<0.0001). In multivariate analysis, IPI at relapse (hazard ratio (HR) 2.409) and transplantation (HR 0.375) independently predicted OS. Third-line salvage chemotherapy can lead to response followed by transplantation and long-term survival in DLBCL patients. However, improvement of salvage efficacy is an urgent need with new drugs.

Original languageEnglish
Pages (from-to)51-7
Number of pages7
JournalBone marrow transplantation
Issue number1
Early online date14 Sept 2015
Publication statusPublished - Jan 2016


  • Adolescent
  • Adult
  • Aged
  • Autografts
  • Disease-Free Survival
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse
  • Male
  • Middle Aged
  • Recurrence
  • Salvage Therapy
  • Stem Cell Transplantation
  • Survival Rate
  • Clinical Trial, Phase III
  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre


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