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
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.