Long-term disease-free survival of patients with advanced mantle-cell lymphoma following high-dose chemotherapy.

Abstract

In advanced stage mantle cell lymphoma, conventional chemotherapy yields a complete remission rate below 40%, and the median survival rate is only about 3 years. Between 1991 and 1996 we treated nine such patients (six male; three female) with high-dose chemotherapy (six of these also with 12 Gy fractionated total body irradiation (TBI)) and peripheral stem cell support (n = 8) or allogeneic bone marrow transplantation (n = 1). The median age was 47 years (range, 28-61). At the time of high-dose chemotherapy, five patients were in first complete remission (CR), two in first partial remission (PR) and two in second remission (CR = 1; PR = 1). High-dose chemotherapy included TBI (12 Gy), etoposide and cyclophosphamide (patients 1-5), TBI and cyclophosphamide (patient 7), busulfan, etoposide and cyclophosphamide (patients 6 and 9), cyclophosphamide and busulfan (patient 8). The patterns of toxicity according to the Bearman score were usually mild (mucositis grade 2, n = 7; renal grade I, n = 2) with no therapy-related fatality. Only one patient developed hepatic toxicity grade III (veno-occlusive disease) but recovered completely. The median time to neutrophil engraftment was 10 days (range, 8-15). After high-dose chemotherapy all patients achieved complete remission. After a median follow-up of 22 months (range, 9.4-64) all patients remain in continuous complete remission. These encouraging results suggest that high-dose chemotherapy can be applied safely and leads to long-term disease-free survival in otherwise incurable disease.

• Authors: N Kröger, M Hoffknecht, P Dreger, W Krüger, W Zeller, A Krüll, M Stockschläder, S Bittner, H J Weh, A R Zander
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 21 Issue 1 Pg. 55-7 (Jan 1998) ISSN: 0268-3369 [Print] England
• PMID: 9486495 (Publication Type: Journal Article)

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Disease-Free Survival
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Lymphoma, Non-Hodgkin (drug therapy, mortality)
• Male
• Middle Aged
• Whole-Body Irradiation