High-dose therapy and autologous stem cell rescue for poor risk and refractory lymphoma

A single centre experience of 123 patients

P. Mahendra, D. Johnson, I. M. Hood, M. A. Scott, P. Barker, G. Bass, H. K. Jestice, D. M. Bloxham, P. Boraks, J. Z. Wimperis, T. P. Baglin, R. E. Marcus

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Over an 8-year period we autografted 123 patients with poor-risk lymphoma. Sixty-three patients had Hodgkin's disease (HD) and 60 non-Hodgkin's lymphoma (NHL). Of the patients with HD, 45 had responsive and 18 resistant disease prior to high-dose therapy. Fifty-three patients with NHL had responsive and seven had resistant disease at the time of transplantation. Seventy-seven patients received autologous bone marrow (BM) rescue, 39 autologous peripheral blood progenitor cell (PBPC) rescue, and seven combined BM and PBPC rescue. High-dose chemotherapy was BEM in 67, BEAM in 39, TBI and cyclophosphamide or etoposide or BCNU in 10, etoposide/mitozantrone in six and etoposide/melphalan in one. There were eight (6.5%) deaths due to treatment-related toxicity, within the first 100 days post-transplantation. Of the patients with HD 41 (65%) are alive at a median follow-up of 39 months (range 2-94). Thirty-three (52%) patients remain in CR. The median DFS of the 63 patients with HD is 34 months (95% CI 7-61). The median DFS for patients transplanted with responsive disease was significantly better than for those transplanted with refractory disease (61 vs 21 months P < 0001). Thirty-five (58%) of the patients with NHL are alive, and 20 (33%) remain in CR. The median DFS for patients transplanted with responsive and refractory disease was 11 months (95% CI 3-19) and 4 months (95% CI 0-9; P = NS) respectively. The median DFS for patients transplanted with HD was significantly better than for patients transplanted with NHL (34 vs 8 months, P < 0.002). In both groups there was no significant difference in DFS in patients receiving one, two, three or more lines of therapy prior to transplantation. In summary, in patients with poor-risk lymphoma who have responsive disease high-dose therapy may result in durable CRs. Conversely, only a small proportion of patients with HD or NHL with resistant disease achieve CR after autologous stem cell rescue.

Original languageEnglish (US)
Pages (from-to)973-978
Number of pages6
JournalBone Marrow Transplantation
Volume17
Issue number6
StatePublished - Jun 1996

Fingerprint

Lymphoma
Stem Cells
Hodgkin Disease
Non-Hodgkin's Lymphoma
Therapeutics
Etoposide
Transplantation
Blood Cells
Bone Marrow
Carmustine
Mitoxantrone
Melphalan
Cyclophosphamide

Keywords

  • Autologous rescue
  • High-dose therapy
  • Lymphoma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

High-dose therapy and autologous stem cell rescue for poor risk and refractory lymphoma : A single centre experience of 123 patients. / Mahendra, P.; Johnson, D.; Hood, I. M.; Scott, M. A.; Barker, P.; Bass, G.; Jestice, H. K.; Bloxham, D. M.; Boraks, P.; Wimperis, J. Z.; Baglin, T. P.; Marcus, R. E.

In: Bone Marrow Transplantation, Vol. 17, No. 6, 06.1996, p. 973-978.

Research output: Contribution to journalArticle

Mahendra, P, Johnson, D, Hood, IM, Scott, MA, Barker, P, Bass, G, Jestice, HK, Bloxham, DM, Boraks, P, Wimperis, JZ, Baglin, TP & Marcus, RE 1996, 'High-dose therapy and autologous stem cell rescue for poor risk and refractory lymphoma: A single centre experience of 123 patients', Bone Marrow Transplantation, vol. 17, no. 6, pp. 973-978.
Mahendra, P. ; Johnson, D. ; Hood, I. M. ; Scott, M. A. ; Barker, P. ; Bass, G. ; Jestice, H. K. ; Bloxham, D. M. ; Boraks, P. ; Wimperis, J. Z. ; Baglin, T. P. ; Marcus, R. E. / High-dose therapy and autologous stem cell rescue for poor risk and refractory lymphoma : A single centre experience of 123 patients. In: Bone Marrow Transplantation. 1996 ; Vol. 17, No. 6. pp. 973-978.
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abstract = "Over an 8-year period we autografted 123 patients with poor-risk lymphoma. Sixty-three patients had Hodgkin's disease (HD) and 60 non-Hodgkin's lymphoma (NHL). Of the patients with HD, 45 had responsive and 18 resistant disease prior to high-dose therapy. Fifty-three patients with NHL had responsive and seven had resistant disease at the time of transplantation. Seventy-seven patients received autologous bone marrow (BM) rescue, 39 autologous peripheral blood progenitor cell (PBPC) rescue, and seven combined BM and PBPC rescue. High-dose chemotherapy was BEM in 67, BEAM in 39, TBI and cyclophosphamide or etoposide or BCNU in 10, etoposide/mitozantrone in six and etoposide/melphalan in one. There were eight (6.5{\%}) deaths due to treatment-related toxicity, within the first 100 days post-transplantation. Of the patients with HD 41 (65{\%}) are alive at a median follow-up of 39 months (range 2-94). Thirty-three (52{\%}) patients remain in CR. The median DFS of the 63 patients with HD is 34 months (95{\%} CI 7-61). The median DFS for patients transplanted with responsive disease was significantly better than for those transplanted with refractory disease (61 vs 21 months P < 0001). Thirty-five (58{\%}) of the patients with NHL are alive, and 20 (33{\%}) remain in CR. The median DFS for patients transplanted with responsive and refractory disease was 11 months (95{\%} CI 3-19) and 4 months (95{\%} CI 0-9; P = NS) respectively. The median DFS for patients transplanted with HD was significantly better than for patients transplanted with NHL (34 vs 8 months, P < 0.002). In both groups there was no significant difference in DFS in patients receiving one, two, three or more lines of therapy prior to transplantation. In summary, in patients with poor-risk lymphoma who have responsive disease high-dose therapy may result in durable CRs. Conversely, only a small proportion of patients with HD or NHL with resistant disease achieve CR after autologous stem cell rescue.",
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AU - Barker, P.

AU - Bass, G.

AU - Jestice, H. K.

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