Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens

Citation
A. Salar et al., Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens, BONE MAR TR, 27(4), 2001, pp. 405-412
Citations number
55
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
Journal title
BONE MARROW TRANSPLANTATION
ISSN journal
0268-3369 → ACNP
Volume
27
Issue
4
Year of publication
2001
Pages
405 - 412
Database
ISI
SICI code
0268-3369(200102)27:4<405:ASCTFC>2.0.ZU;2-5
Abstract
We investigated the impact of the most commonly used preparative regimens o n the outcome of 395 patients with diffuse large cell lymphoma (DLCL), cons ecutively reported to the registry of the Spanish GEL/TAMO, Among them, 139 (35%) were autografted in Ist CR, 86 (22%) in 2nd/3rd CR, 124 (31%) had ch emosensitive disease and 46 (12%) had chemoresistant disease, Conditioning consisted of chemotherapy-only in 348 patients (BEAM, 164; BEAC, 145; and C BV, 39) and radiochemotherapy with CY and TBI in 47, Median times to granul ocyte, platelet recovery and to discharge were significantly shorter in the chemotherapy-only group. Early transplant-related mortality was significan tly higher when using CY-TBI, After a median follow-up of 28 months, overal l survival (OS) at 8 years of patients conditioned with BEAM or BEAC (58% ( 95% CI 50-66%)) was more favorable than with CBV (40% (95% CI 24-56%)), and significantly better than with CY-TBI (31% (95 % CI 18-44%)). Multivariate analysis revealed that patients conditioned with chemotherapy-only regimen s had improved OS, disease-free (DFS) and relapse-free survival (RFS) when compared to those conditioned with CY-TBI, Status at transplant was also a powerful prognostic indicator. We conclude that preparative regimens consis ting of chemotherapy-only seem more efficacious than CY-TBI as conditioning for DLCL, because of faster engraftment and greater anti-lymphoma effect, as indicated by improved OS, DFS and RFS.