Abstract |
Mantle-cell lymphoma (MCL) is characterized by poor prognosis with a median survival of only 3 to 4 years. To improve clinical outcome, the European MCL Network initiated a randomized trial comparing consolidation with myeloablative radiochemotherapy followed by autologous stem cell transplantation (ASCT) to alpha-interferon maintenance (IFN alpha) in first remission. Patients 65 years of age or younger with advanced-stage MCL were assigned to ASCT or IFN alpha after achievement of complete or partial remission by a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like induction therapy. According to the International Prognostic Index (IPI), 43% of patients had a low-risk, 41% a low-intermediate, 11% a high-intermediate, and 6% a high-risk profile. Sixty-two of 122 patients proceeded to ASCT and 60 received IFN alpha. Patients in the ASCT arm experienced a significantly longer progression-free survival (PFS) with a median of 39 months compared with 17 months for patients in the IFN alpha arm (P = .0108). The 3-year overall survival (OS) was 83% after ASCT versus 77% in the IFN group (P = .18). Early consolidation by myeloablative radiochemotherapy followed by ASCT is feasible and results in a significant prolongation of PFS in advanced-stage MCL. Longer follow-up is needed to determine the effect on OS.
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Authors | Martin Dreyling, Georg Lenz, Eva Hoster, Achiel Van Hoof, Christian Gisselbrecht, Rudolf Schmits, Bernd Metzner, Lorenz Truemper, Marcel Reiser, Hjalmar Steinhauer, Jean-Michel Boiron, Marc A Boogaerts, Ali Aldaoud, Vittorio Silingardi, Hanneke C Kluin-Nelemans, Joerg Hasford, Reza Parwaresch, Michael Unterhalt, Wolfgang Hiddemann |
Journal | Blood
(Blood)
Vol. 105
Issue 7
Pg. 2677-84
(Apr 01 2005)
ISSN: 0006-4971 [Print] United States |
PMID | 15591112
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Vincristine
- Doxorubicin
- Cyclophosphamide
- Prednisone
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, adverse effects)
- Combined Modality Therapy
- Cyclophosphamide
(administration & dosage, adverse effects)
- Disease-Free Survival
- Doxorubicin
(administration & dosage, adverse effects)
- Europe
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Lymphoma, Mantle-Cell
(drug therapy, mortality, radiotherapy)
- Male
- Middle Aged
- Prednisone
(administration & dosage, adverse effects)
- Remission Induction
- Survival Analysis
- Transplantation, Autologous
- Vincristine
(administration & dosage, adverse effects)
- Whole-Body Irradiation
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