Myeloablative chemotherapy for chemo-sensitive recurrent follicular lymphoma: potential benefit in second relapse.

Abstract

Defining the role of high-dose therapy with autologous stem cell rescue in the therapeutic algorithm of follicular lymphoma remains a major challenge. In contrast to the acknowledged poor outcome associated with cyclophosphamide/total body irradiation conditioning in heavily pretreated patients, the prognostic impact of the number of previous therapy lines in patients treated with the chemotherapy-only containing regimen, BEAM, is unknown. From 1997 to 2008 80 patients (41 males, 39 females; median age, 51 years; range, 31-67) received high-dose therapy with autologous stem cell rescue with BEAM for relapsed follicular lymphoma at our center. Overall survival and time-to-progression were analyzed according to the number of prior treatment lines. The median number of previous treatment lines was three, with 61% of the patients having received more than three lines (including rituximab in 47%). After a median follow-up of 76 months (range, 14-160), three patients developed secondary myelodysplastic syndrome. The 5-year overall survival rate was 71% and 5-year time-to-progression was 44%. There were no differences in time-to-progression or overall survival according to the number of previous treatment lines or episodes of disease. In conclusion, high-dose therapy with autologous stem cell rescue with BEAM appears to be equally effective in second or third remission of follicular lymphoma.

• Authors: Silvia Montoto, Janet Matthews, Paul Greaves, Debra Lillington, Deborah Anderson, John G Gribben, T Andrew Lister
• Journal: Haematologica (Haematologica) Vol. 98 Issue 4 Pg. 620-5 (Apr 2013) ISSN: 1592-8721 [Electronic] Italy
• PMID: 23144201 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cytarabine
• Etoposide
• Melphalan
• Carmustine

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carmustine (administration & dosage, adverse effects)
• Combined Modality Therapy
• Cytarabine (administration & dosage, adverse effects)
• Etoposide (administration & dosage, adverse effects)
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• In Situ Hybridization
• Kaplan-Meier Estimate
• Lymphoma, Follicular (genetics, pathology, therapy)
• Male
• Melphalan (administration & dosage, adverse effects)
• Middle Aged
• Myelodysplastic Syndromes (chemically induced, genetics)
• Neoplasm Recurrence, Local
• Prognosis
• Remission Induction
• Time Factors
• Transplantation, Autologous
• Treatment Outcome