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Primary treatment with autologous stem cell transplantation in mantle cell lymphoma: outcome related to remission pretransplant

Andersen, NS; Pedersen, L; Elonen, E; Johnson, A; Kolstad, A; Franssila, K; Langholm, R; Ralfkiaer, E; Åkerman, Måns LU and Eriksson, M, et al. (2003) In European Journal of Haematology1987-01-01+01:00 71(2). p.73-80
Abstract
Objective: The aim of the first Nordic mantle cell lymphoma (MCL) protocol was to study the clinical significance of an augmented CHOP induction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) and to examine the prognostic significance of stem cell contamination rates in newly diagnosed patients with MCL. Patients and methods: Forty-one newly diagnosed patients below 66 yr were enrolled and given three series of an augmented CHOP regimen. Responders underwent stem cell mobilization with a fourth course of CHOP, stem cell harvest and ASCT. Stem cell purging was optional in the protocol and followed the routine of each participating centre. The number of tumour cells in the reinfused autografts... (More)
Objective: The aim of the first Nordic mantle cell lymphoma (MCL) protocol was to study the clinical significance of an augmented CHOP induction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) and to examine the prognostic significance of stem cell contamination rates in newly diagnosed patients with MCL. Patients and methods: Forty-one newly diagnosed patients below 66 yr were enrolled and given three series of an augmented CHOP regimen. Responders underwent stem cell mobilization with a fourth course of CHOP, stem cell harvest and ASCT. Stem cell purging was optional in the protocol and followed the routine of each participating centre. The number of tumour cells in the reinfused autografts was estimated by flow cytometry or quantitative PCR. Results: Induction therapy led to complete remission (CR) in 11 of 41 patients (27%), partial remission (PR) in 20 of 41 patients (49%) and no response in nine patients (22%), whereas one patient was not evaluable. Twenty-seven of the 31 responders underwent ASCT and 24 achieved or maintained a CR. The overall and failure-free 4-yr survival on intention-to-treat basis were 51% and 15%, respectively. Among the transplanted patients, a significantly increased failure-free (P < 0.03) and overall survival (P = 0.03) was noted among patients transplanted in CR compared with PR, respectively. By contrast, reinfusion of highly variable numbers of tumour cells with the autografts (range 0.71-80 x 10(6) tumour cells), did not affect outcome. Conclusion: In MCL, an important strategy to improve the outcome will be to intensify the induction chemotherapy. (Less)
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published
subject
keywords
outcome, purging, mantle cell lymphoma, autologous stem cell transplantation, response
in
European Journal of Haematology1987-01-01+01:00
volume
71
issue
2
pages
73 - 80
publisher
Wiley-Blackwell
external identifiers
  • pmid:12890145
  • wos:000184336200001
  • scopus:0043130398
ISSN
1600-0609
DOI
10.1034/j.1600-0609.2003.00093.x
language
English
LU publication?
yes
id
421da20f-2432-4c5e-8adf-1b2408ed00c4 (old id 305697)
date added to LUP
2007-08-22 10:47:32
date last changed
2018-09-16 03:37:35
@article{421da20f-2432-4c5e-8adf-1b2408ed00c4,
  abstract     = {Objective: The aim of the first Nordic mantle cell lymphoma (MCL) protocol was to study the clinical significance of an augmented CHOP induction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) and to examine the prognostic significance of stem cell contamination rates in newly diagnosed patients with MCL. Patients and methods: Forty-one newly diagnosed patients below 66 yr were enrolled and given three series of an augmented CHOP regimen. Responders underwent stem cell mobilization with a fourth course of CHOP, stem cell harvest and ASCT. Stem cell purging was optional in the protocol and followed the routine of each participating centre. The number of tumour cells in the reinfused autografts was estimated by flow cytometry or quantitative PCR. Results: Induction therapy led to complete remission (CR) in 11 of 41 patients (27%), partial remission (PR) in 20 of 41 patients (49%) and no response in nine patients (22%), whereas one patient was not evaluable. Twenty-seven of the 31 responders underwent ASCT and 24 achieved or maintained a CR. The overall and failure-free 4-yr survival on intention-to-treat basis were 51% and 15%, respectively. Among the transplanted patients, a significantly increased failure-free (P &lt; 0.03) and overall survival (P = 0.03) was noted among patients transplanted in CR compared with PR, respectively. By contrast, reinfusion of highly variable numbers of tumour cells with the autografts (range 0.71-80 x 10(6) tumour cells), did not affect outcome. Conclusion: In MCL, an important strategy to improve the outcome will be to intensify the induction chemotherapy.},
  author       = {Andersen, NS and Pedersen, L and Elonen, E and Johnson, A and Kolstad, A and Franssila, K and Langholm, R and Ralfkiaer, E and Åkerman, Måns and Eriksson, M and Kuittinen, O and Geisler, CH},
  issn         = {1600-0609},
  keyword      = {outcome,purging,mantle cell lymphoma,autologous stem cell transplantation,response},
  language     = {eng},
  number       = {2},
  pages        = {73--80},
  publisher    = {Wiley-Blackwell},
  series       = {European Journal of Haematology1987-01-01+01:00},
  title        = {Primary treatment with autologous stem cell transplantation in mantle cell lymphoma: outcome related to remission pretransplant},
  url          = {http://dx.doi.org/10.1034/j.1600-0609.2003.00093.x},
  volume       = {71},
  year         = {2003},
}