High-dose therapy with autologous haematopoietic support in patients with transformed follicular lymphoma: A study of 27 patients from a single centre

James M Foran, J. Apostolidis, D. Papamichael, A. J. Norton, J. Matthews, J. A L Amess, T. A. Lister, A. Z S Rohatiner

Research output: Contribution to journalArticle

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Abstract

Background: The prognosis of patients with transformed follicular lymphoma (FL-t) is poor. The use of high-dose therapy (HDT) with autologous haematopoietic support was therefore evaluated as consolidation of remission. Patients and methods: Twenty-seven patients received high-dose cyclophosphamide and total body irradiation (cyclo + TBI) with autologous bone marrow (BM; n = 24) or peripheral blood progenitor cell support (PBPC; n = 3). BM was treated in vitro with anti-B cell antibodies and complement. Nineteen of 27 patients were treated in first stable remission following transformation. Eight other patients with a history of transformation were treated following a subsequent recurrence of follicular lymphoma (FL). Results: With a median follow-up of 2.4 years, 14 of 27 patients remain alive and in remission; five are alive and free of disease at more than four years. The median survival is 8.5 years. There were two 'early' treatment-related deaths of respiratory failure, and two 'late' deaths of myelodysplastic syndrome (MDS) in remission of lymphoma at 2.8 and 8.5 years. Seven of nine patients having had a recurrence underwent re-biopsy. In two, histology revealed FL, in five, transformed follicular lymphoma. One of the patients with recurrent FL is alive without further therapy, and two of five patients with recurrent FL-t are alive and in remission after further chemotherapy. Conclusions: It is appropriate to consider HDT for younger patients with FL- t in remission. Repeat biopsy should be considered for patients with recurrent disease. There is a risk of late MDS in patients undergoing this treatment.

Original languageEnglish (US)
Pages (from-to)865-869
Number of pages5
JournalAnnals of Oncology
Volume9
Issue number8
DOIs
StatePublished - Aug 1998
Externally publishedYes

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Follicular Lymphoma
Therapeutics
Myelodysplastic Syndromes
Biopsy
Recurrence
Whole-Body Irradiation
Respiratory Insufficiency
Cyclophosphamide
Lymphoma
Blood Cells
Histology
B-Lymphocytes
Stem Cells
Bone Marrow

Keywords

  • Autologous bone marrow transplantation
  • Transformed follicular lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

High-dose therapy with autologous haematopoietic support in patients with transformed follicular lymphoma : A study of 27 patients from a single centre. / Foran, James M; Apostolidis, J.; Papamichael, D.; Norton, A. J.; Matthews, J.; Amess, J. A L; Lister, T. A.; Rohatiner, A. Z S.

In: Annals of Oncology, Vol. 9, No. 8, 08.1998, p. 865-869.

Research output: Contribution to journalArticle

Foran, James M ; Apostolidis, J. ; Papamichael, D. ; Norton, A. J. ; Matthews, J. ; Amess, J. A L ; Lister, T. A. ; Rohatiner, A. Z S. / High-dose therapy with autologous haematopoietic support in patients with transformed follicular lymphoma : A study of 27 patients from a single centre. In: Annals of Oncology. 1998 ; Vol. 9, No. 8. pp. 865-869.
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abstract = "Background: The prognosis of patients with transformed follicular lymphoma (FL-t) is poor. The use of high-dose therapy (HDT) with autologous haematopoietic support was therefore evaluated as consolidation of remission. Patients and methods: Twenty-seven patients received high-dose cyclophosphamide and total body irradiation (cyclo + TBI) with autologous bone marrow (BM; n = 24) or peripheral blood progenitor cell support (PBPC; n = 3). BM was treated in vitro with anti-B cell antibodies and complement. Nineteen of 27 patients were treated in first stable remission following transformation. Eight other patients with a history of transformation were treated following a subsequent recurrence of follicular lymphoma (FL). Results: With a median follow-up of 2.4 years, 14 of 27 patients remain alive and in remission; five are alive and free of disease at more than four years. The median survival is 8.5 years. There were two 'early' treatment-related deaths of respiratory failure, and two 'late' deaths of myelodysplastic syndrome (MDS) in remission of lymphoma at 2.8 and 8.5 years. Seven of nine patients having had a recurrence underwent re-biopsy. In two, histology revealed FL, in five, transformed follicular lymphoma. One of the patients with recurrent FL is alive without further therapy, and two of five patients with recurrent FL-t are alive and in remission after further chemotherapy. Conclusions: It is appropriate to consider HDT for younger patients with FL- t in remission. Repeat biopsy should be considered for patients with recurrent disease. There is a risk of late MDS in patients undergoing this treatment.",
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AU - Norton, A. J.

AU - Matthews, J.

AU - Amess, J. A L

AU - Lister, T. A.

AU - Rohatiner, A. Z S

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N2 - Background: The prognosis of patients with transformed follicular lymphoma (FL-t) is poor. The use of high-dose therapy (HDT) with autologous haematopoietic support was therefore evaluated as consolidation of remission. Patients and methods: Twenty-seven patients received high-dose cyclophosphamide and total body irradiation (cyclo + TBI) with autologous bone marrow (BM; n = 24) or peripheral blood progenitor cell support (PBPC; n = 3). BM was treated in vitro with anti-B cell antibodies and complement. Nineteen of 27 patients were treated in first stable remission following transformation. Eight other patients with a history of transformation were treated following a subsequent recurrence of follicular lymphoma (FL). Results: With a median follow-up of 2.4 years, 14 of 27 patients remain alive and in remission; five are alive and free of disease at more than four years. The median survival is 8.5 years. There were two 'early' treatment-related deaths of respiratory failure, and two 'late' deaths of myelodysplastic syndrome (MDS) in remission of lymphoma at 2.8 and 8.5 years. Seven of nine patients having had a recurrence underwent re-biopsy. In two, histology revealed FL, in five, transformed follicular lymphoma. One of the patients with recurrent FL is alive without further therapy, and two of five patients with recurrent FL-t are alive and in remission after further chemotherapy. Conclusions: It is appropriate to consider HDT for younger patients with FL- t in remission. Repeat biopsy should be considered for patients with recurrent disease. There is a risk of late MDS in patients undergoing this treatment.

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