title: High-dose therapy with autologous stem-cell transplantation (ASCT) after first progression prolonged survival of follicular lymphoma patients included in the prospective GELF 86 protocol.
abstract: BACKGROUND
  Among the 566 patients with follicular lymphomas (FL) included in the GELF 86 prospective trials from October 1986 to September 1995, 372 with progressive/relapsing disease were analyzed retrospectively to identify prognostic factors at first relapse.
  
  
  METHODS
  For progressive FL, patients received mono- (22%) or polychemotherapy (78%) followed by high-dose therapy (HDT) with ASCT for 83 patients (22%). The median time to progression from initial treatment was 23 months (range 3-102 months) and 24% of documented patients (52 of 217) had histological transformation (HT). Salvage therapy produced an overall response in 64% of patients and the five-year survival from progression was 42%.
  
  
  RESULTS
  For patients who underwent HDT with ASCT compared to standard treatment, five-year freedom from second failure was at 42% vs. 16% (P = 0.0001) and five-year survival was 58% vs. 38% (P = 0.0005), respectively. The benefit of HDT and ASCT remained if we consider only patients less than 65 years (five-year survival at 60% vs. 40%; P = 0.001). Multivariate analysis of parameters significant according to univariate analysis found that no ASCT at first progression, age at relapse > 50 years, progression on-therapy were adversely significant on survival.
  
  
  CONCLUSIONS
  HDTwith ASCT compared to standard treatment prolonged remission and survival after first progression of FL patients.
authors.affiliation: Service d'Hématologie, H pital Saint-Louis, Paris, France. pauline.brice@sls.ap-hop-paris.fr
authors.forename: P
authors.initials: P
authors.lastname: Brice
authors.forename: D
authors.initials: D
authors.lastname: Simon
authors.forename: R
authors.initials: R
authors.lastname: Bouabdallah
authors.forename: C
authors.initials: C
authors.lastname: Bélanger
authors.forename: C
authors.initials: C
authors.lastname: Haïoun
authors.forename: C
authors.initials: C
authors.lastname: Thieblemont
authors.forename: H
authors.initials: H
authors.lastname: Tilly
authors.forename: J L
authors.initials: JL
authors.lastname: Harousseau
authors.forename: C
authors.initials: C
authors.lastname: Doyen
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: N
authors.initials: N
authors.lastname: Brousse
authors.forename: P H
authors.initials: PH
authors.lastname: Solal-Céligny
mesh_terms: D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous