title: Myeloablative chemotherapy for chemo-sensitive recurrent follicular lymphoma: potential benefit in second relapse.
abstract: Defining the role of high-dose therapy with autologous stem cell rescue in the therapeutic algorithm of follicular lymphoma remains a major challenge. In contrast to the acknowledged poor outcome associated with cyclophosphamide/total body irradiation conditioning in heavily pretreated patients, the prognostic impact of the number of previous therapy lines in patients treated with the chemotherapy-only containing regimen, BEAM, is unknown. From 1997 to 2008 80 patients (41 males, 39 females; median age, 51 years; range, 31-67) received high-dose therapy with autologous stem cell rescue with BEAM for relapsed follicular lymphoma at our center. Overall survival and time-to-progression were analyzed according to the number of prior treatment lines. The median number of previous treatment lines was three, with 61% of the patients having received more than three lines (including rituximab in 47%). After a median follow-up of 76 months (range, 14-160), three patients developed secondary myelodysplastic syndrome. The 5-year overall survival rate was 71% and 5-year time-to-progression was 44%. There were no differences in time-to-progression or overall survival according to the number of previous treatment lines or episodes of disease. In conclusion, high-dose therapy with autologous stem cell rescue with BEAM appears to be equally effective in second or third remission of follicular lymphoma.
authors.affiliation: Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK. s.montoto@qmul.ac.uk
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoto
authors.forename: Janet
authors.initials: J
authors.lastname: Matthews
authors.forename: Paul
authors.initials: P
authors.lastname: Greaves
authors.forename: Debra
authors.initials: D
authors.lastname: Lillington
authors.forename: Deborah
authors.initials: D
authors.lastname: Anderson
authors.forename: John G
authors.initials: JG
authors.lastname: Gribben
authors.forename: T Andrew
authors.initials: TA
authors.lastname: Lister
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D017403:In Situ Hybridization; D053208:Kaplan-Meier Estimate; D008224:Lymphoma, Follicular / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced / Q000235:genetics; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012074:Remission Induction; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine