High-dose chemotherapy using BEAM without autologous rescue followed by reduced-intensity conditioning allogeneic stem-cell transplantation for refractory or relapsing lymphomas: a comparison of delayed versus immediate transplantation.

Détails

ID Serval
serval:BIB_111854877F3E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
High-dose chemotherapy using BEAM without autologous rescue followed by reduced-intensity conditioning allogeneic stem-cell transplantation for refractory or relapsing lymphomas: a comparison of delayed versus immediate transplantation.
Périodique
Bone marrow transplantation
Auteur(s)
Buser A.S., Stern M., Bucher C., Arber C., Heim D., Halter J., Meyer-Monard S., Stussi G., Lohri A., Ghielmini M., Tichelli A., Passweg J.R., Gratwohl A.
ISSN
0268-3369 (Print)
ISSN-L
0268-3369
Statut éditorial
Publié
Date de publication
03/2007
Peer-reviewed
Oui
Volume
39
Numéro
6
Pages
335-340
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Patients with refractory/relapsing lymphoma are rarely cured by chemotherapy. High-dose chemotherapy (HDC) for tumor debulking followed by reduced-intensity conditioning (RIC) hematopoietic stem-cell transplantation (HSCT) has been advocated as a concept. We previously treated 10 patients (group A) with BEAM chemotherapy followed by delayed RIC HSCT at day 28. We now report on the subsequent 11 patients receiving BEAM followed immediately by fludarabine/total body irradiation and allogeneic HSCT (group B), and compare the outcome to group A patients. Non-hematological toxicity before engraftment was comparable, only gut toxicity was higher in group B. Days in aplasia, days on antibiotics and length of hospital stay were significantly longer in group A. Cumulative incidence of acute (GvHD) >or=grade II and incidence of chronic GvHD were lower in group B. At last follow-up, seven patients in group A were alive, with six of them in complete remission. In group B, nine patients were alive, seven of them in complete remission. No significant difference in estimated 3-year overall survival was seen. These data challenge the initial concept of debulking first and delaying allogeneic RIC HSCT. Allogeneic HSCT with standard BEAM conditioning is a valid alternative for patients with resistant/relapsed lymphoma, which might be considered earlier in the disease course.
Mots-clé
Antineoplastic Combined Chemotherapy Protocols/administration & dosage, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Carmustine/administration & dosage, Cytarabine/administration & dosage, Etoposide/administration & dosage, Female, Graft vs Host Disease, Graft vs Tumor Effect, Hematopoietic Stem Cell Transplantation/methods, Humans, Kaplan-Meier Estimate, Lymphoma/drug therapy, Male, Melphalan/administration & dosage, Remission Induction/methods, Transplantation Conditioning/methods, Transplantation, Homologous
Pubmed
Web of science
Création de la notice
01/11/2019 11:35
Dernière modification de la notice
02/11/2019 7:26
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