Journal
LEUKEMIA & LYMPHOMA
Volume 49, Issue 6, Pages 1062-1073Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428190801923725
Keywords
mantle cell lymphoma; autologous stem cell transplantation; HyperCVAD; CHOP; non-Hodgkin lymphoma
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Funding
- NATIONAL CANCER INSTITUTE [K23CA085479, P01CA044991] Funding Source: NIH RePORTER
- NCI NIH HHS [P01 CA44991, K23 CA085479-06, P01 CA044991, K23CA85479, P01 CA044991-21, K23 CA085479] Funding Source: Medline
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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.
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