High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years
| Autor: | Emmanuel Gyan, Christian Berthou, Steven Le Gouill, Philippe Colombat, Roselyne Delepine, Jean-Pierre Vilque, Philippe Quittet, Bernard Desablens, Antoine Thyss, Philippe Bertrand, Eric Deconinck, Jean-François Ramée, Vincent Delwail, Patrick Michenet, Nina Arakelyan, Remi Gressin, Noel Milpied, Jérôme Jaubert, Hervé Maisonneuve, Cécile Moluçon-Chabrot, Charles Foussard |
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| Přispěvatelé: | Service d'hématologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'hématologie, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel Dieu, Département de biostatistiques, Faculté de Médecine de Tours, Service de pathologie, CHU Orléans, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre hospitalier La Roche-Sur-Yon, Service Hématologie, Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital Jean Bernard, CHU Grenoble, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Laboratoire d'Hématologie [CHU Amiens], CHU Amiens-Picardie, CHU Saint-Etienne, Clinique Catherine de Sienne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), CHU Clermont-Ferrand, CHU Bordeaux [Bordeaux], Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Groupe Ouest-Est des Leucémies et des Autres Maladies du Sang (GOELAMS), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Saas, Philippe |
| Rok vydání: | 2009 |
| Předmět: |
Male
Oncology Transplantation Conditioning MESH: Immunotherapy medicine.medical_treatment Follicular lymphoma Hematopoietic stem cell transplantation Biochemistry MESH: Lymphoma Follicular 0302 clinical medicine Autologous stem-cell transplantation Lymphoma Follicular MESH: Transplantation Conditioning MESH: Middle Aged Bone Marrow Purging Neoplasms Second Primary MESH: Follow-Up Studies Hematology Middle Aged Total body irradiation MESH: Transplantation Autologous 3. Good health Survival Rate 030220 oncology & carcinogenesis [SDV.IMM]Life Sciences [q-bio]/Immunology Female Immunotherapy MESH: Stem Cell Transplantation MESH: Whole-Body Irradiation MESH: Bone Marrow Purging Whole-Body Irradiation medicine.drug Adult MESH: Myeloablative Agonists MESH: Neoplasms Second Primary medicine.medical_specialty [SDV.IMM] Life Sciences [q-bio]/Immunology Adolescent MESH: Survival Rate Cyclophosphamide Immunology Transplantation Autologous Disease-Free Survival 03 medical and health sciences Internal medicine medicine Humans Survival rate MESH: Adolescent Chemotherapy MESH: Humans business.industry MESH: Cyclophosphamide MESH: Adult Cell Biology Myeloablative Agonists medicine.disease MESH: Male Surgery Transplantation MESH: Disease-Free Survival business MESH: Female Follow-Up Studies Stem Cell Transplantation 030215 immunology |
| Zdroj: | Blood Blood, American Society of Hematology, 2009, 113 (5), pp.995-1001. ⟨10.1182/blood-2008-05-160200⟩ |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood-2008-05-160200 |
| Popis: | Autologous stem cell transplantation (ASCT) as first-line therapy for follicular lymphoma (FL) remains controversial. The multicenter study randomized 172 patients with untreated FL for either immunochemotherapy or high-dose therapy (HDT) followed by purged ASCT. Conditioning was performed with total body irradiation (TBI) and cyclophosphamide. The 9-year overall survival (OS) was similar in the HDT and conventional chemotherapy groups (76% and 80%, respectively). The 9-year progression-free survival (PFS) was higher in the ASCT than the chemotherapy group (64% vs 39%; P = .004). A PFS plateau was observed in the HDT group after 7 years. On multivariate analysis, OS and PFS were independently affected by the per-formance status score, the number of nodal areas involved, and the treatment group. Secondary malignancies were more frequent in the HDT than in the chemotherapy group (6 secondary myelodysplastic syndrome/acute myeloid leukemia and 6 second solid tumor cancers vs 1 acute myeloid leukemia, P = .01). The occurrence of a PFS plateau suggests that a subgroup of patients might have their FL cured by ASCT. However, the increased rate of secondary malignancies may discourage the use of purged ASCT in combination with TBI as first-line treatment for FL. This trial has been registered with ClinicalTrials.gov under identifier NCT00696735. |
| Databáze: | OpenAIRE |
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