title: Favorable consolidative effect of high-dose melphalan and total-body irradiation followed by autologous peripheral blood stem cell transplantation after rituximab-containing induction chemotherapy with in vivo purging in relapsed or refractory follicular lymphoma.
abstract: OBJECTIVE
  In this study, we sought to evaluate the efficacy and toxicity of high-dose therapy followed by autologous peripheral blood stem cell transplantation (autoPBSCT) after rituximab-containing induction chemotherapy with in vivo purging for relapsed or refractory chemosensitive advanced-stage follicular lymphoma (FL).
  
  
  METHODS
  A rituximab-containing regimen was used as induction chemotherapy and as in vivo purging before PBSC collection. Patients achieving partial or complete response received a regimen consisting of high-dose melphalan and total-body irradiation (TBI).
  
  
  RESULTS
  A total of 18 patients with a median age of 45 years were enrolled. The number of previous chemotherapy regimens was 2. The principal nonhematologic toxicities were grade 3 febrile neutropenia and diarrhea. One patient experienced pneumocystis pneumonia, 2 developed interstitial pneumonitis, and 1 experienced agammaglobulinemia, all of whom had complete improvement except for the patient having agammaglobulinemia. Grade 4 toxicities were not observed, and there have been neither treatment-related mortality nor secondary malignancy to date. At a median follow-up of 4.0 years, the 4-year estimated overall and failure-free survival rates were 100% and 88.9%, respectively.
  
  
  CONCLUSIONS
  Consolidation of high-dose melphalan and TBI followed by autoPBSCT with in vivo purging is feasible and effective for relapsed or refractory chemosensitive FL. Longer follow-up is needed to confirm the role and late toxicities.
authors: Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan Division of Molecular Medicine, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
authors: Harumi
authors: H
authors: Kato
authors: Hirofumi
authors: H
authors: Taji
authors: Michinori
authors: M
authors: Ogura
authors: Yoshitoyo
authors: Y
authors: Kagami
authors: Yasuhiro
authors: Y
authors: Oki
authors: Akane
authors: A
authors: Tsujimura
authors: Nobukazu
authors: N
authors: Fuwa
authors: Takeshi
authors: T
authors: Kodaira
authors: Masao
authors: M
authors: Seto
authors: Kazuhito
authors: K
authors: Yamamoto
authors: Yasuo
authors: Y
authors: Morishima
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000628:therapy*; D008297:Male; D008558:Melphalan; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D000069283:Rituximab; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D008558:Melphalan