Use of a disease-specific decision aid to determine the minimal clinically important difference between autologous bone marrow transplantation versus standard salvage therapy for patients with high-risk low-grade non-Hodgkin's lymphoma.

Abstract

The introduction of high-dose chemoradiotherapy with autologous peripheral blood stem cell and/or bone marrow transplantation (ABMT) has been used to treat patients with low grade non-Hodgkin's lymphoma who fail to achieve a complete response to standard therapies or who progress after achieving a remission, in an attempt to improve disease-free and overall survival. The introduction of ABMT for the treatment of high-risk low grade non-Hodgkin's lymphoma has introduced an interesting clinical question for patients and physicians. Patients must decide whether the up-front increased morbidity and risk of treatment related mortality (TRM) with an ABMT is worth accepting for an as yet undefined potential benefit over standard salvage therapies (SST). One method of examining the choice between therapeutic options is to determine the minimal clinically important difference (MCID) the patient would require to choose one therapy over its alternate. Many groups have introduced decision aids (DAs) to assist patients in making choices. The primary objective of this study was to describe, using a disease specific DA, the MCID required to choose ABMT over SST in a cohort of patients with high risk low grade non-Hodgkin's lymphoma. (Abstract shortened by UMI.)