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R. Bruna et al.
Overall, 50 patients (37.3% of the whole series) were alive at this follow up without any disease recurrence (18 in the CHOP-R and 32 in the R-HDS arms) since their first CR achievement. Among 98 patients obtaining CR, 39 had disease recurrence (39.8%). In the CHOP-R and R-HDS arms, the last disease recurrence respectively was record- ed at ten years and at seven years from CR achievement. In addition, there were nine late toxic events (1 in CHOP- R and 9 in R-HDS) in patients in their first continuous CR.
For patients reaching CR, the DFS estimate was 57.9% at 13 years. The 13-year DFS estimate was 47.1% for the 39 patients in CR following CHOP-R and 65.3% for the 59 patients in CR following R-HDS (Figure 4).
A subgroup of patients was further monitored for their molecular disease at long-term. After a median of four years of molecular monitoring since treatment completion, of the 24 patients alive in their first CR and evaluable for molecu- lar disease, 20 (83%) patients were still in their first MR.
Figure 2. Main causes of death in the two treatment arms. Main causes of death include deaths due to: lymphoma, secondary malignancies (3 solid tumor, 9 sec- ondary myeloid dysplastic syndrome (sMDS) / acute myeloid leukemia (AML)], non-malignant fatal events (6 fatal cardiovascular complications, 3 documented infec- tions, 1 graft failure following autograft) and other causes (not clearly related to treatment).
Figure 3. Updated overall survival according to end of treatment clinical status. (A) Complete remission (CR) achievement. (B) Molecular remission [polymerase chain reaction negative (PCR)] achievement. No: number; yrs: years.
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