PURPOSE: To evaluate a high-dose treatment regimen of fractionated total-body irradiation (TBI), etoposide, and cyclophosphamide (Cy) followed by autologous stem-cell transplantation (ASCT) in patients with malignant lymphoma. PATIENTS AND METHODS: Fifty-three patients with non-Hodgkin's lymphoma (NHL; n = 43) or Hodgkin's disease (HD; n = 10) received 12.0 Gy of fractionated TBI, etoposide 60 mg/kg, and Cy 100 mg/kg followed by infusion of autologous hematopoietic stem cells. RESULTS: Thirty-one of 53 patients are alive a median of 643 (range, 177 to 1,144) days after transplant. The 2 year Kaplan-Meier (K-M) estimates of survival, event-free survival (EFS), and relapse for all 53 patients were 54%, 45%, and 43%, respectively. Sixteen of 24 patients with less advanced disease and 10 of 29 patients with more advanced disease survive free of disease for K-M estimates of EFS of 61% and 31%, respectively (P = .006). The K-M estimates of relapse were 34% for patients with less advanced disease and 53% (P = .05) for patients with more advanced disease. The K-M estimates of dying from causes other than relapse were 8% in patients with less versus 25% in patients with more advanced disease (P = .09). CONCLUSION: These data indicate that approximately 60% of patients transplanted early after failure of initial therapy for malignant lymphoma are projected to be disease-free more than 2 years after treatment with fractionated TBI, etoposide, and Cy and infusion of autologous hematopoietic stem cells. The transplant-related mortality rate is low and relapse is the main cause of treatment failure in patients with less advanced disease. For patients with more advanced disease, the K-M estimates of both transplant-related deaths (25%) and relapse (53%) remain major problems.
PURPOSE: To evaluate a high-dose treatment regimen of fractionated total-body irradiation (TBI), etoposide, and cyclophosphamide (Cy) followed by autologous stem-cell transplantation (ASCT) in patients with malignant lymphoma. PATIENTS AND METHODS: Fifty-three patients with non-Hodgkin's lymphoma (NHL; n = 43) or Hodgkin's disease (HD; n = 10) received 12.0 Gy of fractionated TBI, etoposide 60 mg/kg, and Cy 100 mg/kg followed by infusion of autologous hematopoietic stem cells. RESULTS: Thirty-one of 53 patients are alive a median of 643 (range, 177 to 1,144) days after transplant. The 2 year Kaplan-Meier (K-M) estimates of survival, event-free survival (EFS), and relapse for all 53 patients were 54%, 45%, and 43%, respectively. Sixteen of 24 patients with less advanced disease and 10 of 29 patients with more advanced disease survive free of disease for K-M estimates of EFS of 61% and 31%, respectively (P = .006). The K-M estimates of relapse were 34% for patients with less advanced disease and 53% (P = .05) for patients with more advanced disease. The K-M estimates of dying from causes other than relapse were 8% in patients with less versus 25% in patients with more advanced disease (P = .09). CONCLUSION: These data indicate that approximately 60% of patients transplanted early after failure of initial therapy for malignant lymphoma are projected to be disease-free more than 2 years after treatment with fractionated TBI, etoposide, and Cy and infusion of autologous hematopoietic stem cells. The transplant-related mortality rate is low and relapse is the main cause of treatment failure in patients with less advanced disease. For patients with more advanced disease, the K-M estimates of both transplant-related deaths (25%) and relapse (53%) remain major problems.
Authors: Auayporn Nademanee; Stephen Forman; Arturo Molina; Henry Fung; David Smith; Andy Dagis; Cheuk Kwok; Dave Yamauchi; Anne-Line Anderson; Peter Falk; Amrita Krishnan; Mark Kirschbaum; Neil Kogut; Ryotaro Nakamura; Margaret O'donnell; Pablo Parker; Leslie Popplewell; Vinod Pullarkat; Roberto Rodriguez; Firoozeh Sahebi; Eileen Smith; David Snyder; Anthony Stein; Ricardo Spielberger; Jasmine Zain; Christine White; Andrew Raubitschek Journal: Blood Date: 2005-07-07 Impact factor: 22.113
Authors: A A Ezzat; E M Ibrahim; R K Stuart; D Ajarim; S Bazarbashi; M O El-Foudeh; M Rahal; A Al-Sayed; J Berry Journal: Med Oncol Date: 2000-02 Impact factor: 3.064
Authors: Sook Hee Hong; Young Seon Hong; In Sook Woo; Yoon Ho Koh; Sang Young Rho; Ji Yean Peak; Myung Ah Lee; Byoung Yong Shim; Jae Ho Byun; Ji Chan Park; Jong Wook Lee; Woo Sung Min; Chun Choo Kim Journal: Cancer Res Treat Date: 2007-06-30 Impact factor: 4.679
Authors: John A Thompson; Richard I Fisher; Michael Leblanc; Stephen J Forman; Oliver W Press; Joseph M Unger; Auayporn P Nademanee; Patrick J Stiff; Stephen H Petersdorf; Alexander Fefer Journal: Blood Date: 2008-02-06 Impact factor: 22.113
Authors: A P Rapoport; B Meisenberg; C Sarkodee-Adoo; A Fassas; S R Frankel; B Mookerjee; N Takebe; R Fenton; M Heyman; A Badros; A Kennedy; M Jacobs; R Hudes; K Ruehle; R Smith; L Kight; S Chambers; M MacFadden; M Cottler-Fox; T Chen; G Phillips; G Tricot Journal: Bone Marrow Transplant Date: 2002-02 Impact factor: 5.483