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

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

Keywords

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

ASJC Scopus subject areas

  • Hematology

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    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, A. M., & 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, 114(2), 333-341. https://doi.org/10.1046/j.1365-2141.2001.02955.x