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Long-term clinical and molecular remissions in patients with follicular lymphoma following high-dose therapy and autologous stem cell transplantation.

AbstractBACKGROUND:
Long-term clinical and molecular remissions in patients with follicular lymphoma (FL) following high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) have been evaluated in only a few studies. Results are especially limited for second-line HDT with BEAM (BCNU, etoposide, cytarabine and melphalan).
PATIENTS AND METHODS:
Sixty patients with FL received ASCT in our institution (18 first-line with total body irradiation and cyclophosphamide, 34 second-line with BEAM and 8 ≥ third-line with BEAM). In the case of long-term remission (>6 years; N = 17), peripheral blood was tested for minimal residual disease by t(14;18)- and IGH-PCR.
RESULTS:
Ten-year overall survival, progression-free survival and freedom from progression (FFP) after first-line ASCT were 79%, 57% and 64% after second-line ASCT 41%, 35% and 42%, respectively. Prognostic factors for FFP were treatment line and FLIPI (Follicular Lymphoma International Prognostic Index). Ten-year FFP for second-line ASCT and low-risk FLIPI was 57%, intermediate risk 37% and high risk 33%. No relapses occurred after 6 years following ASCT. Sixteen patients developed sustained long-term clinical and molecular remissions of up to 17.5 years.
CONCLUSION:
Sustained long-term clinical and molecular remissions can be achieved following ASCT, including HDT with BEAM in second line.
AuthorsB Metzner, C Pott, T H Müller, W Gebauer, J Casper, D Kraemer, B Rosien, S Schumann-Binarsch, R Thole, C H Köhne
JournalAnnals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 24 Issue 6 Pg. 1609-15 (Jun 2013) ISSN: 1569-8041 [Electronic] England
PMID23393125 (Publication Type: Journal Article)
Chemical References
  • Cytarabine
  • Podophyllotoxin
  • Melphalan
  • Carmustine
Topics
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
  • Carmustine (administration & dosage)
  • Cohort Studies
  • Combined Modality Therapy (methods, mortality)
  • Cytarabine (administration & dosage)
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma, Follicular (drug therapy, mortality, surgery)
  • Male
  • Melphalan (administration & dosage)
  • Middle Aged
  • Podophyllotoxin (administration & dosage)
  • Remission Induction (methods)
  • Stem Cell Transplantation (methods, mortality)
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome

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