Intensified preparative regimens and autologous transplantation in refractory or relapsed intermediate grade non-Hodgkin's lymphoma

R. S. Stein, J. P. Greer, S. Goodman, S. J. Brandt, D. S. Morgan, W. R. Macon, T. L. McCurley, S. N. Wolff

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Between September 1986 and June 1998, 99 patients with relapsed or refractory IGL received intensified preparative therapy and underwent autologous transplantation at a single institution. Two intensified preparative regimens were used: cyclophosphamide, etoposide, total body irradiation (CY-VP-TBI) (n = 66) and cyclophosphamide, BCNU, etoposide (CBV) (n = 33). As clinical features and results were not different for the two preparative regimens, results were combined. For all patients undergoing autologous transplantation, 5-year actuarial overall survival (OS) was 34% ± 6%; 5-year event-free survival (EFS) was 26% ± 5%. For patients who responded to primary therapy, salvage therapy, or both, OS was 42% ± 7%; for non-responders to prior therapy, OS was 14% ± 7%, P < 0.025. OS was better among patients responding to salvage therapy (50% ± 9%), than among patients who had a complete response to initial therapy, but failed to respond or were untested/unevaluable with respect to salvage therapy (26% ± 10%; P < 0.025). On multivariate analysis, response to salvage therapy was associated with survival following autologous transplantation (P < 0.005). Treatment related mortality was 9% overall and only 6% after G-CSF and GM-CSF were introduced into routine clinical practice. High-intensity preparative therapy is highly effective, with acceptable treatment-related mortality, in patients with IGL who have responded to induction therapy, salvage therapy, or both. The best responses are observed in patients responding to salvage therapy. Randomized prospective studies will be needed to further define the role of intensified preparative regimens.

Original languageEnglish (US)
Pages (from-to)257-262
Number of pages6
JournalBone Marrow Transplantation
Volume25
Issue number3
StatePublished - 2000
Externally publishedYes

Fingerprint

Autologous Transplantation
Salvage Therapy
Non-Hodgkin's Lymphoma
Survival
Etoposide
Therapeutics
Granulocyte-Macrophage Colony-Stimulating Factor
Cyclophosphamide
Carmustine
Mortality
Whole-Body Irradiation
Granulocyte Colony-Stimulating Factor
Disease-Free Survival
Multivariate Analysis
Prospective Studies

Keywords

  • Autologous
  • Intermediate-grade
  • Lymphoma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Stein, R. S., Greer, J. P., Goodman, S., Brandt, S. J., Morgan, D. S., Macon, W. R., ... Wolff, S. N. (2000). Intensified preparative regimens and autologous transplantation in refractory or relapsed intermediate grade non-Hodgkin's lymphoma. Bone Marrow Transplantation, 25(3), 257-262.

Intensified preparative regimens and autologous transplantation in refractory or relapsed intermediate grade non-Hodgkin's lymphoma. / Stein, R. S.; Greer, J. P.; Goodman, S.; Brandt, S. J.; Morgan, D. S.; Macon, W. R.; McCurley, T. L.; Wolff, S. N.

In: Bone Marrow Transplantation, Vol. 25, No. 3, 2000, p. 257-262.

Research output: Contribution to journalArticle

Stein, RS, Greer, JP, Goodman, S, Brandt, SJ, Morgan, DS, Macon, WR, McCurley, TL & Wolff, SN 2000, 'Intensified preparative regimens and autologous transplantation in refractory or relapsed intermediate grade non-Hodgkin's lymphoma', Bone Marrow Transplantation, vol. 25, no. 3, pp. 257-262.
Stein, R. S. ; Greer, J. P. ; Goodman, S. ; Brandt, S. J. ; Morgan, D. S. ; Macon, W. R. ; McCurley, T. L. ; Wolff, S. N. / Intensified preparative regimens and autologous transplantation in refractory or relapsed intermediate grade non-Hodgkin's lymphoma. In: Bone Marrow Transplantation. 2000 ; Vol. 25, No. 3. pp. 257-262.
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AU - Goodman, S.

AU - Brandt, S. J.

AU - Morgan, D. S.

AU - Macon, W. R.

AU - McCurley, T. L.

AU - Wolff, S. N.

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