Improved outcome of patients with relapsed/refractory Hodgkin lymphoma with a new fotemustine‐based high‐dose chemotherapy regimen
Autor: | Nicola Di Renzo, Paolo Di Carlo, Domenico Pastore, Nicola Cascavilla, Erminio Bonizzoni, Giuseppe Messina, Anna Mele, R. Matera, Potito Rosario Scalzulli, Chiara Ciochetto, Anxur Merenda, Antonello Pinto, Francesco Lanza, Vincenzo Pavone, Massimo Di Nicola, Maurizio Musso, Umberto Vitolo, Enrico Orciuolo, Stella Santarone, Renato Scalone, Gianpaolo Marcacci, Angelo Michele Carella, Daniela Donnarumma, Tiziana Moscato, Alessandra Crescimanno |
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Rok vydání: | 2015 |
Předmět: |
Male
Oncology Melphalan Transplantation Conditioning autologous stem cell transplantation medicine.medical_treatment Salvage therapy Kaplan-Meier Estimate Nitrosourea Compounds 0302 clinical medicine Autologous stem-cell transplantation Antineoplastic Combined Chemotherapy Protocols High-dose chemotherapy Medicine Prospective Studies Registries Child Etoposide Haematological Malignancy Graft Survival Cytarabine Hematopoietic Stem Cell Transplantation Hematology Middle Aged fotemustine Hodgkin Disease Treatment Outcome 030220 oncology & carcinogenesis high‐dose chemotherapy Female Research Paper medicine.drug Adult medicine.medical_specialty Adolescent NO Young Adult 03 medical and health sciences Organophosphorus Compounds Internal medicine Humans Aged Salvage Therapy Chemotherapy business.industry Autologous stem cell transplantation Fotemustine Hodgkin lymphoma Drug Evaluation Positron-Emission Tomography Surgery Regimen business 030215 immunology |
Zdroj: | British Journal of Haematology |
ISSN: | 1365-2141 0007-1048 |
Popis: | High-dose chemotherapy (HDT) with autologous stem cell transplantation is the standard of care for relapsed/refractory (RR) Hodgkin lymphoma (HL). Given that HDT may cure a sizeable proportion of patients refractory to first salvage, development of newer conditioning regimens remains a priority. We present the results of a novel HDT regimen in which carmustine was substituted by a third-generation chloroethylnitrosourea, fotemustine, with improved pharmacokinetics and safety (FEAM; fotemustine, etoposide, cytarabine, melphalan) in 122 patients with RR-HL accrued into a prospective registry-based study. Application of FEAM resulted in a 2-year progression-free survival (PFS) of 73·8% [95% confidence interval (CI), 0·64-0·81] with median PFS, overall survival and time to progression yet to be reached. The 2-year risk of progression adjusted for the competitive risk of death was 19·4% (95% CI, 0·12-0·27) for the entire patient population. Most previously established independent risk factors, except for fluorodeoxyglucose ((18) (F) FDG)-uptake, were unable to predict for disease progression and survival after FEAM. Although 32% of patients had (18) (F) FDG-positrin emission tomography-positive lesions before HDT, the 2-year risk of progression adjusted for competitive risk of death was 19·4% (95% CI; 0·12-0·27). No unusual acute toxicities or early/late pulmonary adverse events were registered. FEAM emerges as an ideal HDT regimen for RR-HL patients typically pre-exposed to lung-damaging treatments. |
Databáze: | OpenAIRE |
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