title: A prospective phase II study of RICE re-induction, then high-dose fludarabine and busulfan, followed by autologous or allogeneic blood stem cell transplantation for indolent b-cell lymphoma.
abstract: BACKGROUND
  Optimal high dose conditioning and relative roles of autologous stem cell transplantation (autoSCT) or allogeneic (alloSCT) for indolent lymphoma are uncertain.
  
  
  METHODS
  A prospective phase II study evaluated autoSCT and alloSCT depending on availability of sibling donor after uniform rituximab, ifosfamide, carboplatin, etoposide (RICE) re-induction and novel myeloablative fludarabine, busulfan (FluBu) conditioning for patients with mantle cell lymphoma in first remission or first relapse, or indolent lymphoma in first or second relapse.
  
  
  RESULTS
  The 68 patients (autoSCT, 36; syngeneic [syn], 1; alloSCT, 31) who were accrued had a 10-month median progression-free survival (PFS) after their last chemotherapy treatment. After RICE, the overall response rate was 69%, and 24 of 39 patients (62%) cleared marrow of lymphoma. Treatment-related mortality at 100 days and 1 year after FluBu were both 0% post-auto/synSCT, but were 6% and 26% post-alloSCT, respectively. At a median follow-up of 60 months, the respective 5-year overall survival and PFS rates were 71% and 46% for auto/synSCT, and were 58% and 47% for alloSCT. Quality of life assessment 1-year post-SCT favoured auto/synSCT.
  
  
  CONCLUSIONS
  The protocol was feasible, FluBu was well-tolerated, and both auto/synSCT and alloSCT conferred similar 5-year PFS following the RICE-FluBu protocol.
authors.affiliation: Department of Oncology and Medicine, University of Calgary, and Tom Baker Cancer, Centre, Canada. douglas.stewart@albertahealthservices.ca
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Stewart
authors.forename: Qiuli
authors.initials: Q
authors.lastname: Duan
authors.forename: Linda
authors.initials: L
authors.lastname: Carlson
authors.forename: James A
authors.initials: JA
authors.lastname: Russell
authors.forename: Nizar J
authors.initials: NJ
authors.lastname: Bahlis
authors.forename: Peter
authors.initials: P
authors.lastname: Duggan
authors.forename: Wanda
authors.initials: W
authors.lastname: Hasegawa
authors.forename: Michael
authors.initials: M
authors.lastname: Voralia
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D000069283:Rituximab; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D005047:Etoposide; D016190:Carboplatin; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine; D007069:Ifosfamide