title: Autologous bone marrow transplantation as consolidation therapy may prolong remission in newly diagnosed high-risk follicular lymphoma: a pilot study of 34 cases.
abstract: We evaluated early intensification followed by autologous bone marrow transplantation (ABMT) using marrow purged by mafosfamide in patients with high-risk low-grade follicular lymphoma (LGFL) reaching a status of minimal disease (MD). Thirty-four patients entered the program. All fulfilled at least one of the following criteria at diagnosis: a bulky tumor > 7 cm; three or more adenopathies > 3 cm; massive pleural or peritoneal effusion; massive splenomegaly; B symptoms; platelet count < 100 x 10(9)/l. Twenty-one patients had bone marrow involvement. Twenty-six patients received ACVBP, and eight CVP as front-line therapy. Twenty-one (62%) patients achieved MD status, 18 reached intensification. At 4 years, the time to treatment failure is 55 +/- 9%, and the probability of persisting remission is 75 +/- 11%. Comparison by intention to treat of the 26 patients who received ACVBP as front-line therapy to 14 historical high-risk LGFL similarly treated in our institution without intensification, showed better results for the intensified group (P = 0.04 for both probability of persisting remission and time to treatment failure). These results indicate that early intensification using marrow purged with mafosfamide is a therapeutic option which may bring benefit to patients with high-risk LGFL.
authors.affiliation: Service d'Hématologie Clinique, Centre Hospitalier Dr Schaffner, Lens, France.
authors.forename: P
authors.initials: P
authors.lastname: Morel
authors.forename: J P
authors.initials: JP
authors.lastname: Laporte
authors.forename: M P
authors.initials: MP
authors.lastname: Noel
authors.forename: M
authors.initials: M
authors.lastname: Lopez
authors.forename: L
authors.initials: L
authors.lastname: Douay
authors.forename: L
authors.initials: L
authors.lastname: Fouillard
authors.forename: L
authors.initials: L
authors.lastname: Detourmignies
authors.forename: B
authors.initials: B
authors.lastname: Dupriez
authors.forename: S
authors.initials: S
authors.lastname: Lesage
authors.forename: F
authors.initials: F
authors.lastname: Isnard
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016019:Survival Analysis; D014182:Transplantation, Autologous
chemical_list: C048341:mafosfamide; D003520:Cyclophosphamide