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Effect of remission status and induction chemotherapy regimen on outcome of autologous stem cell transplantation for mantle cell lymphoma.

Till, Brian G and Gooley, Theodore A and Crawford, Nathan and Gopal, Ajay K and Maloney, David G and Petersdorf, Stephen H and Pagel, John M and Holmberg, Leona and Bensinger, William and Press, Oliver W (2008) Effect of remission status and induction chemotherapy regimen on outcome of autologous stem cell transplantation for mantle cell lymphoma. Leukemia & lymphoma, 49 (6). pp. 1062-1073. ISSN 1029-2403

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Abstract

We analysed the outcomes of autologous stem cell transplantation (ASCT) following high-dose therapy with respect to remission status at the time of transplantation and induction regimen used in 56 consecutive patients with mantle cell lymphoma (MCL). Twenty-one patients received induction chemotherapy with HyperCVAD with or without rituximab (+/-R) followed by ASCT in first complete or partial remission (CR1/PR1), 15 received CHOP (+/-R) followed by ASCT in CR1/PR1 and 20 received ASCT following disease progression. Estimates of overall and progression-free survival (PFS) at 3 years among patients transplanted in CR1/PR1 were 93% and 63% compared with 46% and 36% for patients transplanted with relapsed/refractory disease, respectively. The hazard of mortality among patients transplanted with relapsed/refractory disease was 6.09 times that of patients transplanted in CR1/PR1 (P = 0.006). Patients in the CHOP (+/-R) group had a higher risk of failure for PFS compared with patients in the HyperCVAD (+/-R) group, though the difference did not reach statistical significance (hazard ratio 3.67, P = 0.11). These results suggest that ASCT in CR1/PR1 leads to improved survival outcomes for patients with MCL compared to ASCT with relapsed/refractory disease, and a HyperCVAD (+/-R) induction regimen may be associated with an improved PFS among patients transplanted in CR1/PR1.

Item Type: Article
Additional Information: This article is available to subscribers only via the URL above.
DOI: 10.1080/10428190801923725
PubMed ID: 18452065
NIHMSID: NIHMS147578
PMCID: PMC2769072
Grant Numbers: P01 CA44991, K23CA85479
Keywords or MeSH Headings: Adult; Aged; Antibodies, Monoclonal/therapeutic use; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Combined Modality Therapy; Cyclophosphamide/therapeutic use; Dexamethasone/therapeutic use; Disease-Free Survival; Doxorubicin/therapeutic use; Female; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, Mantle-Cell/drug therapy/therapy; Male; Middle Aged; Neoplasm Recurrence, Local/therapy; Prednisone/therapeutic use; Remission Induction; Survival Rate; Transplantation, Autologous; Vincristine/therapeutic use;
Subjects: Therapeutics > Transplantation > Stem Cell transplantation
Diseases > Hematologic and lymphatic diseases > Lymphoma
Therapeutics > Drug Therapy
Depositing User: Library Staff
Date Deposited: 22 Sep 2009 18:48
Last Modified: 14 Feb 2012 14:42
URI: http://authors.fhcrc.org/id/eprint/338

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