Intensive chemotherapy and consolidation with high dose therapy and autologous stem cell transplant in patients with mantle cell lymphoma
| Autor: | Leon Bernal-Mizrachi, Jean L. Koff, Rajni Sinha, Nassoma King, Miray Seward, Sagar Lonial, Pareen J. Shenoy, Christopher R. Flowers, Amelia Langston, Mary Jo Lechowicz, Alexander J. Ambinder, Edmund K. Waller, Ajay K. Nooka, Loretta J. Nastoupil, Jonathan L. Kaufman |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Vincristine Cyclophosphamide Kaplan-Meier Estimate Lymphoma Mantle-Cell Transplantation Autologous Disease-Free Survival International Prognostic Index Prednisone hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols Outcome Assessment Health Care medicine Humans Aged Neoplasm Staging Proportional Hazards Models Dose-Response Relationship Drug business.industry Hematology Middle Aged medicine.disease Combined Modality Therapy Surgery R-CHOP Regimen Cytarabine Female Mantle cell lymphoma Rituximab business Stem Cell Transplantation medicine.drug |
| Zdroj: | Leukemia & Lymphoma. 56:383-389 |
| ISSN: | 1029-2403 1042-8194 |
| DOI: | 10.3109/10428194.2014.921296 |
| Popis: | Mantle cell lymphoma (MCL) remains incurable with conventional chemotherapy without consensus on the optimal initial treatment. We examined our single center experience with frontline therapy for patients with MCL in consecutive cases diagnosed 1995-2011. Among 81 patients, median age was 59 (28% were ≥65 years of age), 95% had stage III/IV disease and 54% had a low risk MCL International Prognostic Index score. Thirty-five percent (n=28) received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and 65% received R-HCVAD (rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with high-dose methotrexate/cytarabine; n=53). Forty-one patients were consolidated with autologous stem cell transplant (ASCT). There were no significant differences in 2-year survival for R-CHOP versus R-HCVAD (p=0.10) or for ASCT versus observation (p=0.06). After controlling for clinical factors, R-HCVAD followed by ASCT was associated with superior progression-free survival (hazard ratio 0.26, 95% confidence interval 0.09-0.75). |
| Databáze: | OpenAIRE |
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