title: Final analysis of the UKLG LY02 trial comparing 6-8 cycles of CHOP with 3 cycles of CHOP followed by a BEAM autograft in patients <65 years with poor prognosis histologically aggressive NHL.
abstract: This trial involved 457 patients and sought to assess the value of early intensification with autologous transplantation in patients with poor prognosis histologically aggressive non-Hodgkin lymphoma (NHL) showing a response to initial CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) chemotherapy. Randomization was made at the time of diagnosis with 223 assigned to continuing CHOP and 234 to 3 cycles of CHOP followed by a BEAM (carmustine, etoposide, cytarabine, melphalan) autograft. Analysis was on an intention to treat basis. After the initial three cycles of CHOP 19% of the whole group were in complete response (CR) and 53% in partial remission (PR). At the end of treatment 86% of patients in the CHOP arm had responded with 58% in CR. In the high-dose therapy arm the overall response rate was 83% with 64% in CR (difference between arms not significant). The progression-free survival (PFS) and overall survival at 5 years for the continuing CHOP arm were 38% and 50% respectively, and for the autograft arm were 44% and 50% (differences not significant). Of the patients who attained CR and subsequently relapsed, there were no long-term survivors in the autograft recipients compared to 46% of the continuing CHOP recipients (P = 0.0008). In conclusion, no survival benefit was demonstrated for an early autograft in first response.
authors.affiliation: NCRI UK Lymphoma Group, CRUK and UCL Cancer Trials Centre UCL, London, UK. d.linch@ucl.ac.uk
authors.forename: David C
authors.initials: DC
authors.lastname: Linch
authors.forename: Lynny
authors.initials: L
authors.lastname: Yung
authors.forename: Paul
authors.initials: P
authors.lastname: Smith
authors.forename: Ken
authors.initials: K
authors.lastname: Maclennan
authors.forename: Andrew
authors.initials: A
authors.lastname: Jack
authors.forename: Barry
authors.initials: B
authors.lastname: Hancock
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.forename: Peter
authors.initials: P
authors.lastname: Hoskin
authors.forename: Wendi
authors.initials: W
authors.lastname: Qian
authors.forename: Harald
authors.initials: H
authors.lastname: Holte
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Boesen
authors.forename: Andrew
authors.initials: A
authors.lastname: Grigg
authors.forename: Peter
authors.initials: P
authors.lastname: Browett
authors.forename: Marek
authors.initials: M
authors.lastname: Trneny
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use*; D002330:Carmustine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D008558:Melphalan; D002330:Carmustine