TY - JOUR
T1 - Pilot study of tandem high-dose chemotherapy and autologous stem cell transplantation with a novel combination of regimens in patients with poor risk lymphoma
AU - Papadopoulos, K. P.
AU - Noguera-Irizarry, W.
AU - Wiebe, L.
AU - Hesdorffer, C. S.
AU - Garvin, J.
AU - Nichols, G. L.
AU - Vahdat, L. H.
AU - Lo, K. M.S.
AU - Skerrett, D.
AU - Bernstein, D.
AU - Sharpe, E.
AU - Savage, D. G.
N1 - Funding Information:
This work was supported in part by the Julie Gould Fun d (KPP) and an unrestricted grant from Bristol Myers Squibb.
PY - 2005/9
Y1 - 2005/9
N2 - In an effort to improve the outcome of poor-risk lymphoma patients, we evaluated a novel regimen of tandem high-dose chemotherapy (THDC) with autologous stem cell transplantation. A total of 41 patients (median age 40 years, range 15-68 years) with poor-risk non-Hodgkin's lymphoma and Hodgkin's disease were enrolled. THDC consisted of melphalan (180mg/ m2) and escalating dose mitoxantrone (30-50mg/m2) (MMt) for the first conditioning regimen, and thiotepa (500mg/ m2), carboplatin (800mg/m2), and escalating dose etoposide phosphate (400-850mg/m2), (ETCb) as the second regimen. In all, 31 patients (76%) completed both transplants, with a median time between transplants of 55 days (range 26-120). The maximum tolerated dose was determined as 40mg/m2 for mitoxantrone and 550mg/m2 for etoposide phosphate. The overall toxic death rate was 12%. Following high-dose chemotherapy, 10 of 24 evaluable patients (42%) were in CR. The two-year overall survival and event-free survival is 67% (95% CI, 52-81%) and 45%, (95% CI, 29-61%) for the 41 patients enrolled; and 69% (95% CI, 525-586%) and 48% (95% CI, 30-67%) for the 31 patients completing both transplants. This THDC regimen is feasible but with notable toxicity in heavily pretreated patients; its role in the current treatment of high-risk lymphoma remains to be determined.
AB - In an effort to improve the outcome of poor-risk lymphoma patients, we evaluated a novel regimen of tandem high-dose chemotherapy (THDC) with autologous stem cell transplantation. A total of 41 patients (median age 40 years, range 15-68 years) with poor-risk non-Hodgkin's lymphoma and Hodgkin's disease were enrolled. THDC consisted of melphalan (180mg/ m2) and escalating dose mitoxantrone (30-50mg/m2) (MMt) for the first conditioning regimen, and thiotepa (500mg/ m2), carboplatin (800mg/m2), and escalating dose etoposide phosphate (400-850mg/m2), (ETCb) as the second regimen. In all, 31 patients (76%) completed both transplants, with a median time between transplants of 55 days (range 26-120). The maximum tolerated dose was determined as 40mg/m2 for mitoxantrone and 550mg/m2 for etoposide phosphate. The overall toxic death rate was 12%. Following high-dose chemotherapy, 10 of 24 evaluable patients (42%) were in CR. The two-year overall survival and event-free survival is 67% (95% CI, 52-81%) and 45%, (95% CI, 29-61%) for the 41 patients enrolled; and 69% (95% CI, 525-586%) and 48% (95% CI, 30-67%) for the 31 patients completing both transplants. This THDC regimen is feasible but with notable toxicity in heavily pretreated patients; its role in the current treatment of high-risk lymphoma remains to be determined.
KW - Autologous
KW - Lymphoma
KW - Tandem transplantation
UR - http://www.scopus.com/inward/record.url?scp=31044450886&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=31044450886&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1705103
DO - 10.1038/sj.bmt.1705103
M3 - Article
C2 - 16044139
AN - SCOPUS:31044450886
SN - 0268-3369
VL - 36
SP - 491
EP - 497
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 6
ER -