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Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group

Geisler, Christian H.; Kolstad, Arne; Laurell, Anna; Andersen, Niels S.; Pedersen, Lone B.; Jerkeman, Mats LU ; Eriksson, Mikael LU ; Nordstrom, Marie; Kimby, Eva and Boesen, Anne Marie, et al. (2008) In Blood 112(7). p.2687-2693
Abstract
Mantle cell lymphoma (MCL) is considered incurable. Intensive immunochemotherapy with stem cell support has not been tested in large, prospective series. In the 2nd Nordic MCL trial, we treated 160 consecutive, untreated patients younger than 66 years in a phase 2 protocol with dose-intensified induction immunochemotherapy with rituximab (R) + cyclophosphamide, vincristine, doxorubicin, prednisone (maxi-CHOP), alternating with R + highdose cytarabine. Responders received highdose chemotherapy with BEAM or BEAC carmustine, etoposide, cytarabine, and melphalan/ cyclophosphamide) with R-in vivo purged autologous stem cell support. Overall and complete response was achieved in 96% and 54%, respectively. The 6-year overall, event-free, and... (More)
Mantle cell lymphoma (MCL) is considered incurable. Intensive immunochemotherapy with stem cell support has not been tested in large, prospective series. In the 2nd Nordic MCL trial, we treated 160 consecutive, untreated patients younger than 66 years in a phase 2 protocol with dose-intensified induction immunochemotherapy with rituximab (R) + cyclophosphamide, vincristine, doxorubicin, prednisone (maxi-CHOP), alternating with R + highdose cytarabine. Responders received highdose chemotherapy with BEAM or BEAC carmustine, etoposide, cytarabine, and melphalan/ cyclophosphamide) with R-in vivo purged autologous stem cell support. Overall and complete response was achieved in 96% and 54%, respectively. The 6-year overall, event-free, and progression-free survival were 70%, 56%, and 66%, respectively, with no relapses occurring after 5 years. Multivariate analysis showed Ki-67 to be the sole independent predictor of event-free survival. The nonrelapse mortality was 5%. The majority of stem cell products and patients assessed with polymerase chain reaction (PCR) after transplantation were negative. Compared with our historical control, the Nordic MCL- 1 trial, the event- free, overall, and progression- free survival, the duration of molecular remission, and the proportion of PCR- negative stem cell products were significantly increased (P < .001). Intensive immunochemotherapy with in vivo purged stem cell support can lead to long-term progression- free survival of MCL and perhaps cure. Registered at www. isrctn. org as # ISRCTN 87866680. (Less)
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published
subject
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Blood
volume
112
issue
7
pages
2687 - 2693
publisher
American Society of Hematology
external identifiers
  • wos:000259402600022
  • scopus:53449089095
ISSN
1528-0020
DOI
10.1182/blood-2008-03-147025
language
English
LU publication?
yes
id
e156d60e-1773-4815-a6c5-064fbf3b59bf (old id 1287332)
date added to LUP
2009-01-22 12:44:29
date last changed
2017-11-12 03:24:44
@article{e156d60e-1773-4815-a6c5-064fbf3b59bf,
  abstract     = {Mantle cell lymphoma (MCL) is considered incurable. Intensive immunochemotherapy with stem cell support has not been tested in large, prospective series. In the 2nd Nordic MCL trial, we treated 160 consecutive, untreated patients younger than 66 years in a phase 2 protocol with dose-intensified induction immunochemotherapy with rituximab (R) + cyclophosphamide, vincristine, doxorubicin, prednisone (maxi-CHOP), alternating with R + highdose cytarabine. Responders received highdose chemotherapy with BEAM or BEAC carmustine, etoposide, cytarabine, and melphalan/ cyclophosphamide) with R-in vivo purged autologous stem cell support. Overall and complete response was achieved in 96% and 54%, respectively. The 6-year overall, event-free, and progression-free survival were 70%, 56%, and 66%, respectively, with no relapses occurring after 5 years. Multivariate analysis showed Ki-67 to be the sole independent predictor of event-free survival. The nonrelapse mortality was 5%. The majority of stem cell products and patients assessed with polymerase chain reaction (PCR) after transplantation were negative. Compared with our historical control, the Nordic MCL- 1 trial, the event- free, overall, and progression- free survival, the duration of molecular remission, and the proportion of PCR- negative stem cell products were significantly increased (P &lt; .001). Intensive immunochemotherapy with in vivo purged stem cell support can lead to long-term progression- free survival of MCL and perhaps cure. Registered at www. isrctn. org as # ISRCTN 87866680.},
  author       = {Geisler, Christian H. and Kolstad, Arne and Laurell, Anna and Andersen, Niels S. and Pedersen, Lone B. and Jerkeman, Mats and Eriksson, Mikael and Nordstrom, Marie and Kimby, Eva and Boesen, Anne Marie and Kuittinen, Outi and Lauritzsen, Grete F. and Nilsson-Ehle, Herman and Ralfkiaer, Elisabeth and Åkerman, Måns and Ehinger, Mats and Sundstrom, Christer and Langholm, Ruth and Delabie, Jan and Karjalainen-Lindsberg, Marja-Liisa and Brown, Peter and Elonen, Erkki},
  issn         = {1528-0020},
  language     = {eng},
  number       = {7},
  pages        = {2687--2693},
  publisher    = {American Society of Hematology},
  series       = {Blood},
  title        = {Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group},
  url          = {http://dx.doi.org/10.1182/blood-2008-03-147025},
  volume       = {112},
  year         = {2008},
}