Effect of remission status and induction chemotherapy regimen on outcome of autologous stem cell transplantation for mantle cell lymphoma.

Publication Type:

Journal Article

Source:

Leukemia & lymphoma, Volume 49, Issue 6, p.1062-73 (2008)

Keywords:

2008, Adult, Aged, Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Combined Chemotherapy Protocols, Biologics Production Core Facility, Cell Processing Core Facility, Center-Authored Paper, Clinical Research Division, Combined Modality Therapy, Cyclophosphamide, Dexamethasone, Disease-Free Survival, Doxorubicin, Female, Flow Cytometry Core Facility, hematopoietic stem cell transplantation, Humans, Lymphoma, Mantle-Cell, Male, Middle Aged, Neoplasm Recurrence, Local, Prednisone, Remission Induction, Research Trials Office Core Facility - Biostatistics Service, Shared Resources, Survival Rate, Transplantation, Autologous, Vincristine

Abstract:

We analysed the outcomes of autologous stem cell transplantation (ASCT) following high-dose therapy with respect to remission status at the time of transplantation and induction regimen used in 56 consecutive patients with mantle cell lymphoma (MCL). Twenty-one patients received induction chemotherapy with HyperCVAD with or without rituximab (+/-R) followed by ASCT in first complete or partial remission (CR1/PR1), 15 received CHOP (+/-R) followed by ASCT in CR1/PR1 and 20 received ASCT following disease progression. Estimates of overall and progression-free survival (PFS) at 3 years among patients transplanted in CR1/PR1 were 93% and 63% compared with 46% and 36% for patients transplanted with relapsed/refractory disease, respectively. The hazard of mortality among patients transplanted with relapsed/refractory disease was 6.09 times that of patients transplanted in CR1/PR1 (P = 0.006). Patients in the CHOP (+/-R) group had a higher risk of failure for PFS compared with patients in the HyperCVAD (+/-R) group, though the difference did not reach statistical significance (hazard ratio 3.67, P = 0.11). These results suggest that ASCT in CR1/PR1 leads to improved survival outcomes for patients with MCL compared to ASCT with relapsed/refractory disease, and a HyperCVAD (+/-R) induction regimen may be associated with an improved PFS among patients transplanted in CR1/PR1.