Pilot study of tandem high-dose chemotherapy and autologous stem cell transplantation with a novel combination of regimens in patients with poor risk lymphoma
| Autor: | Charles S. Hesdorffer, Donna Skerrett, L Wiebe, Kyriakos P. Papadopoulos, D Bernstein, K M S Lo, James Garvin, L H Vahdat, W Noguera-Irizarry, E Sharpe, Gwen Nichols, David G. Savage |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Risk Melphalan medicine.medical_specialty Transplantation Conditioning Adolescent Lymphoma Maximum Tolerated Dose medicine.medical_treatment Pilot Projects ThioTEPA Transplantation Autologous Gastroenterology chemistry.chemical_compound Autologous stem-cell transplantation Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Aged Transplantation Mitoxantrone Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Hematology Middle Aged Survival Analysis Carboplatin Surgery Regimen chemistry Female business medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 36:491-497 |
| ISSN: | 1476-5365 0268-3369 |
| Popis: | In an effort to improve the outcome of poor-risk lymphoma patients, we evaluated a novel regimen of tandem high-dose chemotherapy (THDC) with autologous stem cell transplantation. A total of 41 patients (median age 40 years, range 15-68 years) with poor-risk non-Hodgkin's lymphoma and Hodgkin's disease were enrolled. THDC consisted of melphalan (180 mg/m2) and escalating dose mitoxantrone (30-50 mg/m2) (MMt) for the first conditioning regimen, and thiotepa (500 mg/m2), carboplatin (800 mg/m2), and escalating dose etoposide phosphate (400-850 mg/m2), (ETCb) as the second regimen. In all, 31 patients (76%) completed both transplants, with a median time between transplants of 55 days (range 26-120). The maximum tolerated dose was determined as 40 mg/m2 for mitoxantrone and 550 mg/m2 for etoposide phosphate. The overall toxic death rate was 12%. Following high-dose chemotherapy, 10 of 24 evaluable patients (42%) were in CR. The two-year overall survival and event-free survival is 67% (95% CI, 52-81%) and 45%, (95% CI, 29-61%) for the 41 patients enrolled; and 69% (95% CI, 525-586%) and 48% (95% CI, 30-67%) for the 31 patients completing both transplants. This THDC regimen is feasible but with notable toxicity in heavily pretreated patients; its role in the current treatment of high-risk lymphoma remains to be determined. |
| Databáze: | OpenAIRE |
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