PURPOSE: The role for high-dose therapy and autologous stem-cell transplantation in mantle-cell lymphoma (MCL) is unknown. We retrospectively analyzed patients with chemosensitive disease who underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody-purged autologous bone marrow transplantation (ABMT) for MCL in first remission, as well as following relapse from conventional therapy. PATIENTS AND METHODS: Between August 1985 and April 1996, 28 patients underwent ABMT using a uniform ablative regimen with cyclophosphamide and total-body irradiation (TBI) and a bone marrow-purging regimen. Re-review of original tissue demonstrated that all patients had morphologic, phenotypic, and genotypic characteristics of MCL. MCL was the original diagnosis in 21 patients, whereas seven patients had a prior diagnosis of diffuse small cleaved-cell lymphoma. RESULTS: Twenty patients received multiple regimens before ABMT, while eight underwent ABMT in first complete remission (CR)/partial remission (PR) following CHOP induction. At bone marrow harvest, only 18% of patients were in CR and overt BM infiltration was present in 57%. Following cyclophosphamide/TBI, no treatment-related deaths were seen. Nineteen of 28 patients have relapsed at a median time of 21 months (range, 3 to 70). Of eight patients transplanted in first CR/PR, five have relapsed. Nine patients are in continuous CR with a median follow-up time of 24 months (range, 10 to 135). Disease-free survival (DFS) and overall survival (OS) are estimated to be 31% and 62% at 4 years, respectively. CONCLUSION: ABMT using cyclophosphamide/TBI conditioning may at best be effective in only a small fraction of patients with relapsed MCL. The lack of plateau with a median follow-up time of 24 months suggests cure may not be achievable. The role of this therapy in patients in first remission requires more study using better induction therapy to enhance the CR rate before ABMT.
PURPOSE: The role for high-dose therapy and autologous stem-cell transplantation in mantle-cell lymphoma (MCL) is unknown. We retrospectively analyzed patients with chemosensitive disease who underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody-purged autologous bone marrow transplantation (ABMT) for MCL in first remission, as well as following relapse from conventional therapy. PATIENTS AND METHODS: Between August 1985 and April 1996, 28 patients underwent ABMT using a uniform ablative regimen with cyclophosphamide and total-body irradiation (TBI) and a bone marrow-purging regimen. Re-review of original tissue demonstrated that all patients had morphologic, phenotypic, and genotypic characteristics of MCL. MCL was the original diagnosis in 21 patients, whereas seven patients had a prior diagnosis of diffuse small cleaved-cell lymphoma. RESULTS: Twenty patients received multiple regimens before ABMT, while eight underwent ABMT in first complete remission (CR)/partial remission (PR) following CHOP induction. At bone marrow harvest, only 18% of patients were in CR and overt BM infiltration was present in 57%. Following cyclophosphamide/TBI, no treatment-related deaths were seen. Nineteen of 28 patients have relapsed at a median time of 21 months (range, 3 to 70). Of eight patients transplanted in first CR/PR, five have relapsed. Nine patients are in continuous CR with a median follow-up time of 24 months (range, 10 to 135). Disease-free survival (DFS) and overall survival (OS) are estimated to be 31% and 62% at 4 years, respectively. CONCLUSION:ABMT using cyclophosphamide/TBI conditioning may at best be effective in only a small fraction of patients with relapsed MCL. The lack of plateau with a median follow-up time of 24 months suggests cure may not be achievable. The role of this therapy in patients in first remission requires more study using better induction therapy to enhance the CR rate before ABMT.
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: Rémy Gressin; Sylvie Caulet-Maugendre; Eric Deconinck; Olivier Tournilhac; Emmanuel Gyan; Marie Pierre Moles; Abderrazak El Yamani; Jerome Cornillon; Jean François Rossi; Steven Le Gouill; Gérard Lepeu; Ghandi Damaj; Philippe Solal Celigny; Hervé Maisonneuve; Bernadette Corront; Jean Pierre Vilque; Philippe Casassus; Thierry Lamy; Marc Colonna; Philippe Colombat Journal: Haematologica Date: 2010-03-10 Impact factor: 9.941
Authors: Brian G Till; Theodore A Gooley; Nathan Crawford; Ajay K Gopal; David G Maloney; Stephen H Petersdorf; John M Pagel; Leona Holmberg; William Bensinger; Oliver W Press Journal: Leuk Lymphoma Date: 2008-06
Authors: Ryan D Cassaday; Katherine A Guthrie; Elizabeth L Budde; Leslie Thompson; Brian G Till; Oliver W Press; Thomas R Chauncey; John M Pagel; Stephen H Petersdorf; Maria Corinna Palanca-Wessels; Mary Philip; William I Bensinger; Leona A Holmberg; Andrei Shustov; Damian J Green; Edward N Libby; David G Maloney; Ajay K Gopal Journal: Biol Blood Marrow Transplant Date: 2013-07-17 Impact factor: 5.742