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 language | English |
|---|---|
| Pages (from-to) | 333-341 |
| Number of pages | 9 |
| Journal | British Journal of Haematology |
| Volume | 114 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2001 |
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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 journal › Article
}
TY - JOUR
T1 - Intensification of salvage treatment with high-dose sequential chemotherapy improves the outcome of patients with refractory or relapsed aggressive non-Hodgkin's lymphoma
AU - Cortelazzo, Sergio
AU - Rambaldi, Alessandro
AU - Rossi, Andrea
AU - Oldani, Elena
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
PY - 2001
Y1 - 2001
N2 - 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.
AB - 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.
KW - Autologous haematopoietic progenitor cell transplantation
KW - Chemosensitivity
KW - High-dose sequential regimen
KW - Refractory NHL
KW - Relapsed NHL
UR - http://www.scopus.com/inward/record.url?scp=0034882693&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034882693&partnerID=8YFLogxK
U2 - 10.1046/j.1365-2141.2001.02955.x
DO - 10.1046/j.1365-2141.2001.02955.x
M3 - Article
VL - 114
SP - 333
EP - 341
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 2
ER -