BACKGROUND: The efficacy of first-line intensive chemotherapy plus transplantation of autologous hematopoietic stem cells in adults with disseminated aggressive lymphoma is unknown. METHODS: We compared high-dose therapy plus autologous stem-cell support with the standard regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in a randomized trial. The patients were 15 to 60 years of age, had untreated aggressive lymphoma, and were at low, low intermediate, or high intermediate risk of death (i.e., a maximum of two adverse prognostic factors) according to the age-adjusted International Prognostic Index. The primary outcome was event-free survival at five years. RESULTS: Of 207 consecutive patients, 197 underwent randomization; 99 were assigned to receiveCHOP, and 98 to receive high-dose chemotherapy plus stem-cell transplantation. Overall, 78 percent of the patients completed the assigned treatment; the median follow-up was four years. The estimated event-free survival rate (+/-SD) at five years was significantly higher among patients who received high-dose therapy than among patients who received CHOP (55+/-5 percent vs. 37+/-5 percent, P=0.037). Among patients with a high intermediate risk of death, according to the age-adjusted International Prognostic Index, the five-year survival rate was significantly higher after high-dose therapy than after CHOP (74+/-6 percent vs. 44+/-7 percent, P=0.001). CONCLUSIONS: High-dose chemotherapy with autologous stem-cell support is superior to CHOP in adults with disseminated aggressive lymphoma. Copyright 2004 Massachusetts Medical Society
RCT Entities:
BACKGROUND: The efficacy of first-line intensive chemotherapy plus transplantation of autologous hematopoietic stem cells in adults with disseminated aggressive lymphoma is unknown. METHODS: We compared high-dose therapy plus autologous stem-cell support with the standard regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in a randomized trial. The patients were 15 to 60 years of age, had untreated aggressive lymphoma, and were at low, low intermediate, or high intermediate risk of death (i.e., a maximum of two adverse prognostic factors) according to the age-adjusted International Prognostic Index. The primary outcome was event-free survival at five years. RESULTS: Of 207 consecutive patients, 197 underwent randomization; 99 were assigned to receive CHOP, and 98 to receive high-dose chemotherapy plus stem-cell transplantation. Overall, 78 percent of the patients completed the assigned treatment; the median follow-up was four years. The estimated event-free survival rate (+/-SD) at five years was significantly higher among patients who received high-dose therapy than among patients who received CHOP (55+/-5 percent vs. 37+/-5 percent, P=0.037). Among patients with a high intermediate risk of death, according to the age-adjusted International Prognostic Index, the five-year survival rate was significantly higher after high-dose therapy than after CHOP (74+/-6 percent vs. 44+/-7 percent, P=0.001). CONCLUSIONS: High-dose chemotherapy with autologous stem-cell support is superior to CHOP in adults with disseminated aggressive lymphoma. Copyright 2004 Massachusetts Medical Society
Authors: S Garciaz; D Coso; J-M Schiano de Collela; F Broussais; A-M Stoppa; T Aurran; C Chabannon; A Helvig; L Xerri; D Blaise; R Bouabdallah Journal: Bone Marrow Transplant Date: 2015-11-02 Impact factor: 5.483
Authors: Theodoros P Vassilakopoulos; Gerassimos A Pangalis; Andreas Katsigiannis; Sotirios G Papageorgiou; Nikos Constantinou; Evangelos Terpos; Alexandra Zorbala; Effimia Vrakidou; Panagiotis Repoussis; Christos Poziopoulos; Zacharoula Galani; Maria N Dimopoulou; Stella I Kokoris; Sotirios Sachanas; Christina Kalpadakis; Evagelia M Dimitriadou; Marina P Siakantaris; Marie-Christine Kyrtsonis; John Dervenoulas; Meletios A Dimopoulos; John Meletis; Paraskevi Roussou; Panayiotis Panayiotidis; Photis Beris; Maria K Angelopoulou Journal: Oncologist Date: 2012-01-26
Authors: Patrick J Stiff; Joseph M Unger; James R Cook; Louis S Constine; Stephen Couban; Douglas A Stewart; Thomas C Shea; Pierluigi Porcu; Jane N Winter; Brad S Kahl; Thomas P Miller; Raymond R Tubbs; Deborah Marcellus; Jonathan W Friedberg; Kevin P Barton; Glenn M Mills; Michael LeBlanc; Lisa M Rimsza; Stephen J Forman; Richard I Fisher Journal: N Engl J Med Date: 2013-10-31 Impact factor: 91.245