The impact of total body irradiation on the outcome of patients with follicular lymphoma treated with autologous stem-cell transplantation in the modern era: a retrospective study of the EBMT Lymphoma Working Party.

Abstract

BACKGROUND:

The aim of this study was to investigate the impact of the high-dose regimen on the outcome of patients with follicular lymphoma (FL) having had autologous stem-cell transplantation (ASCT) in a recent time period.

PATIENTS:

Between 1995 and 2007, 2233 patients with FL had their first ASCT with either a total body irradiation (TBI)-containing regimen or carmustin, etoposide, cytarabine and melphalan (BEAM), of which 47% were autografted in first remission.

RESULTS:

After a median observation time of 73 months (interquartile range 30-107), 5- and 10-year non-relapse mortality (NRM) was similar (6% and 10% in both groups). No significant NRM differences became evident after multivariate adjustment for confounders. Secondary malignancies were observed in 9.7% and 7.9% of the patients after TBI and BEAM (P = 0.19), which were treatment-related myelodysplastic syndromes/acute myelogenous leukaemia (t-MDS/AML) in 3.4% and 2.8% (P = 0.57). The median time to t-MDS/AML was around 50 months in both groups. Because of a lower relapse incidence, TBI was associated with better event-free survival reaching statistical significance in the patients transplanted in first remission but not in those transplanted beyond first remission.

CONCLUSIONS:

In patients with FL who received TBI-based ASCT after 1995 increased NRM and t-MDS/AML risks did not emerge compared with BEAM while disease control was at least equivalent.

• Authors: I El-Najjar, A Boumendil, J J Luan, R Bouabdallah, K Thomson, M Mohty, P Colombat, P Biron, H Tilly, M Pfreundschuh, C Cordonnier, A Sureda, J Y Cahn, J P Vernant, J Gribben, G Cook, A P Haynes, A Ferrant, H Finel, S Montoto, P Dreger, Lymphoma Working Party of the European Group for Blood and Marrow Transplantation (EBMT)
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 25 Issue 11 Pg. 2224-2229 (Nov 2014) ISSN: 1569-8041 [Electronic] England
• PMID: 25193988 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Cytarabine
• Rituximab
• Podophyllotoxin
• Melphalan
• Carmustine

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Monoclonal, Murine-Derived (administration & dosage, adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Carmustine (administration & dosage, adverse effects)
• Combined Modality Therapy
• Cytarabine (administration & dosage, adverse effects)
• Disease-Free Survival
• Female
• Humans
• Lymphoma, Follicular (drug therapy, pathology, radiotherapy)
• Male
• Melphalan (administration & dosage, adverse effects)
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy, pathology, radiotherapy)
• Podophyllotoxin (administration & dosage, adverse effects)
• Remission Induction
• Rituximab
• Stem Cell Transplantation
• Transplantation, Autologous
• Whole-Body Irradiation
• Young Adult