title: Long-term clinical and molecular remissions in patients with follicular lymphoma following high-dose therapy and autologous stem cell transplantation.
abstract: BACKGROUND
  Long-term clinical and molecular remissions in patients with follicular lymphoma (FL) following high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) have been evaluated in only a few studies. Results are especially limited for second-line HDT with BEAM (BCNU, etoposide, cytarabine and melphalan).
  
  
  METHODS
  Sixty patients with FL received ASCT in our institution (18 first-line with total body irradiation and cyclophosphamide, 34 second-line with BEAM and 8 ≥ third-line with BEAM). In the case of long-term remission (>6 years; N = 17), peripheral blood was tested for minimal residual disease by t(14;18)- and IGH-PCR.
  
  
  RESULTS
  Ten-year overall survival, progression-free survival and freedom from progression (FFP) after first-line ASCT were 79%, 57% and 64% after second-line ASCT 41%, 35% and 42%, respectively. Prognostic factors for FFP were treatment line and FLIPI (Follicular Lymphoma International Prognostic Index). Ten-year FFP for second-line ASCT and low-risk FLIPI was 57%, intermediate risk 37% and high risk 33%. No relapses occurred after 6 years following ASCT. Sixteen patients developed sustained long-term clinical and molecular remissions of up to 17.5 years.
  
  
  CONCLUSIONS
  Sustained long-term clinical and molecular remissions can be achieved following ASCT, including HDT with BEAM in second line.
authors: Department of Oncology and Haematology, Klinikum Oldenburg, University Hospital, Oldenburg, Germany. metzner.bernd@klinikum-oldenburg.de
authors: B
authors: B
authors: Metzner
authors: C
authors: C
authors: Pott
authors: T H
authors: TH
authors: Müller
authors: W
authors: W
authors: Gebauer
authors: J
authors: J
authors: Casper
authors: D
authors: D
authors: Kraemer
authors: B
authors: B
authors: Rosien
authors: S
authors: S
authors: Schumann-Binarsch
authors: R
authors: R
authors: Thole
authors: C H
authors: CH
authors: Köhne
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002330:Carmustine / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods / Q000401:mortality; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D011034:Podophyllotoxin / Q000008:administration & dosage; D012074:Remission Induction / Q000379:methods; D033581:Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine
keywords: MRD; autologous stem-cell transplantation; follicular lymphoma; long-term remission; relapse; secondary malignancies