Intensification of salvage treatment with high-dose sequential chemotherapy improves the outcome of patients with refractory or relapsed aggressive non-Hodgkin's lymphoma

Sergio Cortelazzo, Alessandro Rambaldi, Andrea Rossi, Elena Oldani, Michele Ghielmini, Fabio Benedetti, Corrado Tarella, Francesco Zaglio, Umberto Vitolo, Massimo Di Nicola, Enrico Pogliani, Franco Cavalli, Alessandro Massimo Gianni, Tiziano Barbui

Research output: Contribution to journalArticle

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Abstract

The aim of the present study was to retrospectively evaluate whether a high-dose sequential chemotherapy programme (HDS; cyclophosphamide, methotrexate, etoposide) administered prior to autologous transplantation could optimize the salvage of patients with refractory or relapsed aggressive non-Hodgkin's lymphoma. Between 1985 and 1999, 103 patients (median age 43 years, range 16-65) from eight Italian centres and one Swiss centre, with refractory (n = 38) or relapsed (n = 65) diffuse large B-cell and T-cell lymphoma, were treated using HDS followed by high-dose regimens with autologous haematopoietic stem cell transplantation. Eighty-three patients responded to the HDS regimen (81%, 95% C.I., 73-88%) and 79 eventually achieved a complete response (CR) after autotransplantation (90%, 95% C.I., 81-96%). None of 20 cases resistant to HDS attained CR. Treatment-related mortality was 4%. After a median follow-up of 24 months (range 6-174 months), 3-year estimates of overall survival, event-free survival and disease-free survival were 47% (95% C.I., 36-59%), 44% (95% C.I., 34-54%) and 64% (95% C.I., 50-74%) respectively. Multivariate analysis showed that chemosensitivity to HDS represented the strongest predictor of both CR and survival. This retrospective study shows that salvage treatment using HDS had relatively low toxicity and was associated with remarkable response rates, allowing further effective therapy with high-dose autograft programmes.

Original languageEnglish
Pages (from-to)333-341
Number of pages9
JournalBritish Journal of Haematology
Volume114
Issue number2
DOIs
Publication statusPublished - 2001

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Salvage Therapy
Non-Hodgkin's Lymphoma
Autologous Transplantation
Drug Therapy
Disease-Free Survival
Survival
T-Cell Lymphoma
Hematopoietic Stem Cell Transplantation
Autografts
Etoposide
Methotrexate
Cyclophosphamide
B-Lymphocytes
Multivariate Analysis
Retrospective Studies
Mortality
Therapeutics

Keywords

  • Autologous haematopoietic progenitor cell transplantation
  • Chemosensitivity
  • High-dose sequential regimen
  • Refractory NHL
  • Relapsed NHL

ASJC Scopus subject areas

  • Hematology

Cite this

Intensification of salvage treatment with high-dose sequential chemotherapy improves the outcome of patients with refractory or relapsed aggressive non-Hodgkin's lymphoma. / Cortelazzo, Sergio; Rambaldi, Alessandro; Rossi, Andrea; Oldani, Elena; Ghielmini, Michele; Benedetti, Fabio; Tarella, Corrado; Zaglio, Francesco; Vitolo, Umberto; Di Nicola, Massimo; Pogliani, Enrico; Cavalli, Franco; Gianni, Alessandro Massimo; Barbui, Tiziano.

In: British Journal of Haematology, Vol. 114, No. 2, 2001, p. 333-341.

Research output: Contribution to journalArticle

Cortelazzo, S, Rambaldi, A, Rossi, A, Oldani, E, Ghielmini, M, Benedetti, F, Tarella, C, Zaglio, F, Vitolo, U, Di Nicola, M, Pogliani, E, Cavalli, F, Gianni, AM & Barbui, T 2001, 'Intensification of salvage treatment with high-dose sequential chemotherapy improves the outcome of patients with refractory or relapsed aggressive non-Hodgkin's lymphoma', British Journal of Haematology, vol. 114, no. 2, pp. 333-341. https://doi.org/10.1046/j.1365-2141.2001.02955.x
Cortelazzo, Sergio ; Rambaldi, Alessandro ; Rossi, Andrea ; Oldani, Elena ; Ghielmini, Michele ; Benedetti, Fabio ; Tarella, Corrado ; Zaglio, Francesco ; Vitolo, Umberto ; Di Nicola, Massimo ; Pogliani, Enrico ; Cavalli, Franco ; Gianni, Alessandro Massimo ; Barbui, Tiziano. / Intensification of salvage treatment with high-dose sequential chemotherapy improves the outcome of patients with refractory or relapsed aggressive non-Hodgkin's lymphoma. In: British Journal of Haematology. 2001 ; Vol. 114, No. 2. pp. 333-341.
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AU - Ghielmini, Michele

AU - Benedetti, Fabio

AU - Tarella, Corrado

AU - Zaglio, Francesco

AU - Vitolo, Umberto

AU - Di Nicola, Massimo

AU - Pogliani, Enrico

AU - Cavalli, Franco

AU - Gianni, Alessandro Massimo

AU - Barbui, Tiziano

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