High dose melphalan is an adequate preparative regimen for autologous hematopoietic stem cell transplantation in relapsed/refractory lymphoma.

Autor: Fernández-Gutiérrez JA; Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico., Reyes-Cisneros OA; Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico., Litzow MR; Hematology, Mayo Clinic Minnesota, Rochester, MN, USA., Bojalil-Alvarez L; Benemérita Universidad Autónoma de Puebla, Puebla, Mexico., Garcia-Villasenor E; Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico., Gómez-Gomez ET; Hematología, Hospital Universitario de Nuevo León 'José Eleuterio González', Monterrey, Mexico., Murrieta-Alvarez I; Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico., Gomez-Almaguer D; Hematología, Hospital Universitario de Nuevo León 'José Eleuterio González', Monterrey, Mexico., Gutierrez-Aguirre CH; Instituto de Cancerología, Clínica Las Americas, Medellín, Colombia., Karduss-Urueta AJ; Instituto de Cancerología, Clínica Las Americas, Medellín, Colombia., Ruiz-Delgado GJ; Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico., Ruiz-Arguelles GJ; Centro de Hematología y Medicina Interna de Puebla, Universidad Popular Autonoma del Estado de Puebla, Puebla, Mexico.
Jazyk: angličtina
Zdroj: Hematology (Amsterdam, Netherlands) [Hematology] 2022 Dec; Vol. 27 (1), pp. 449-455.
DOI: 10.1080/16078454.2022.2059630
Abstrakt: Introduction: High-dose melphalan (HD-Mel) has been successfully employed in autografting patients with multiple myeloma. An advantage of this regimen is that the total dose of Mel can be delivered in a single day, being particularly useful when non-frozen hematopoietic stem cells are employed in the autograft.
Material and Methods: All consecutive patients with R/R lymphomas, both HL and NHL studied and treated at two different centers were prospectively included in a study of ASCT employing a single dose of HD-Mel (200 mg/m 2 ). A group of R/R HL or NHL autografted employing BEAM-like preparative regimens was constructed matched by diagnosis and age. The primary endpoint of the study was overall survival (OS), the secondary endpoint was event-free survival (EFS).
Results: Twenty-five R/R HL/NHL patients were prospectively accrued in the study. There were 8 (32%) females, 13 (52%) patients had at least 1 adverse effect: 7 (28%) developed mucositis, 5 (20%) neutropenic fever, and 6 (24%) grade IV nausea. In the HD-Mel group, median overall survival (OS) was not achieved and OS at 36 months was 71%, the transplant-related mortality being 0%. In the control group, median OS was not achieved and the 36-month OS was 76%, results not statistically significant ( p 0.5). The EFS was also similar in both groups ( p 0.5).
Conclusion: HD-Mel alone is non-inferior to a BEAM-like regimen as a preparative regimen for autografting patients with R/R HL and NHL. The regimen is adequate to graft persons with non-frozen stem cells.
Databáze: MEDLINE
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