Sequential intensive treatment with the F-MACHOP regimen (+/- radiotherapy) and autologous stem cell transplantation for primary systemic CD30 (Ki-1)--positive anaplastic large cell lymphoma in adults.
Most of the adult patients with primary systemic CD30 (Ki-1)-positive anaplastic large cell lymphoma (ALCL) reported in the literature have been treated with combination chemotherapy (CHT), with only an occasional patient being autotransplanted, mostly after relapse. Here we report a series of 19 patients treated at our Institution with a sequential intensive therapeutic program including CHT (the F-MACHOP regimen given for 6 cycles), radiotherapy (RT), and autologous stem cell transplantation (ASCT) after conditioning with the BAVC regimen. Eleven of 19 (58%) patients achieved a complete remission (CR) after CHT; 3 after RT and 4 after ASCT (1 patient is still not evaluable for response to ASCT). The actuarial overall survival is 100% at a median of 49 months from diagnosis and the actuarial disease free survival is 100% at a median of 41 months from the time CR was reached. These data suggest that ALCL can be successfully managed with a sequential intensive treatment that prevents early relapses and projects these patients as long-term survivors.
Fanin
R
R
Department of Bone Marrow Transplantation, University Hospital, Udine, Italy.
Silvestri
F
F
Geromin
A
A
Cerno
M
M
Infanti
L
L
Zaja
F
F
Barillari
G
G
Savignano
C
C
Rinaldi
C
C
Damiani
D
D
Baccarani
M
M
D000293:Adolescent; D000328:Adult; D000677:Amsacrine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
D000677:Amsacrine; D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D002330:Carmustine; D011241:Prednisone; D008727:Methotrexate