TY - JOUR
T1 - VACOP-B, high-dose cyclophosphamide and high-dose therapy with peripheral blood progenitor cell rescue for aggressive non-Hodgkin's lymphoma with bone marrow involvement
T2 - A study by the non-Hodgkin's Lymphoma Co- operative Study Group
AU - Santini, Gino
AU - Coser, Paolo
AU - Congiu, Angela Marina
AU - Salvagno, Luigi
AU - De Souza, Carmino
AU - Sertoli, Mario Roberto
AU - Olivieri, Attilio
AU - Chisesi, Teodoro
AU - Rubagotti, Alessandra
AU - Truini, Mauro
AU - Contu, Antonio
AU - Porcellini, Adolfo
AU - Zambaldi, Gino
AU - Nati, Sandro
AU - Marino, Gennaro
AU - Rizzoli, Vittorio
PY - 2000/2
Y1 - 2000/2
N2 - Background and Objectives. Sequential treatment with the addition of high-dose therapy (HDT) and peripheral blood progenitor cell (PBPC) rescue has been reported to be active as front-line therapy in aggressive non- Hodgkin's lymphoma (NHL) with bone marrow (BM) involvement. We designed an intensive sequential therapy as front-line therapy in this subset of patients and conducted a phase II study. Design and Methods. Patients with aggressive non-Hodgkin's lymphoma and BM involvement at diagnosis received 8 weeks of VACOP-B chemotherapy as induction therapy. The second phase included high- dose cyclophosphamide (HDCY) (7 g/m2) with granulocyte colony-stimulating factor (G-CSF) followed by leukaphereses. The third phase included HDT according to the BEAM protocol or melphalan (140 mg/m2) plus total body irradiation (8 Gy in a single dose). Results. Forty patients were included in the study. According to the intention-to-treat, after VACOP-B, 11 (27.5%) and 22 (55%) patients achieved complete remission (CR) and partial remission (PR), respectively. Thirty-four received HDCY. After HDCY, 18 patients (45%) were in CR and 13 (32.5%) in PR. Twenty-nine underwent HDT plus peripheral blood cell rescue (PBPC) rescue. At the completion of treatment 29 patients (72.5%) were in CR, and 3 patients (7.5%) in PR. The actuarial 3-year overall survival, disease free survival and failure free survival are 48%, 55% and 40%, respectively. Overall severe toxicity was 7.5%. Interpretation and Conclusions. This phase II study suggests that the intensified treatment described is feasible and active in aggressive NHL with BM involvement. A randomized trial is now underway to test this approach. (C) 2000, Ferrata Storti Foundation.
AB - Background and Objectives. Sequential treatment with the addition of high-dose therapy (HDT) and peripheral blood progenitor cell (PBPC) rescue has been reported to be active as front-line therapy in aggressive non- Hodgkin's lymphoma (NHL) with bone marrow (BM) involvement. We designed an intensive sequential therapy as front-line therapy in this subset of patients and conducted a phase II study. Design and Methods. Patients with aggressive non-Hodgkin's lymphoma and BM involvement at diagnosis received 8 weeks of VACOP-B chemotherapy as induction therapy. The second phase included high- dose cyclophosphamide (HDCY) (7 g/m2) with granulocyte colony-stimulating factor (G-CSF) followed by leukaphereses. The third phase included HDT according to the BEAM protocol or melphalan (140 mg/m2) plus total body irradiation (8 Gy in a single dose). Results. Forty patients were included in the study. According to the intention-to-treat, after VACOP-B, 11 (27.5%) and 22 (55%) patients achieved complete remission (CR) and partial remission (PR), respectively. Thirty-four received HDCY. After HDCY, 18 patients (45%) were in CR and 13 (32.5%) in PR. Twenty-nine underwent HDT plus peripheral blood cell rescue (PBPC) rescue. At the completion of treatment 29 patients (72.5%) were in CR, and 3 patients (7.5%) in PR. The actuarial 3-year overall survival, disease free survival and failure free survival are 48%, 55% and 40%, respectively. Overall severe toxicity was 7.5%. Interpretation and Conclusions. This phase II study suggests that the intensified treatment described is feasible and active in aggressive NHL with BM involvement. A randomized trial is now underway to test this approach. (C) 2000, Ferrata Storti Foundation.
KW - Aggressive non-Hodgkin's lymphoma
KW - Bone marrow involvement
KW - High-dose therapy
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M3 - Article
C2 - 10681723
AN - SCOPUS:0034091507
VL - 85
SP - 160
EP - 166
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 2
ER -