Safety and efficacy of high-dose cyclophosphamide, etoposide and ranimustine regimen followed by autologous peripheral blood stem cell transplant for patients with diffuse large B-cell lymphoma.
We retrospectively evaluated the safety and efficacy of high-dose chemotherapy consisting of cyclophosphamide, etoposide and ranimustine (CEM) with autologous peripheral blood stem cell transplant (PBSCT) in 55 adult patients with relapsed or high-risk de novo diffuse large B-cell lymphoma (DLBCL) or DLBCL associated with follicular lymphoma. This included 36 patients in the upfront setting in their first complete remission. The median follow-up of 42 patients surviving at the time of the analysis was 52 months (range 1-159). Relapse or disease progression after PBSCT was a frequent cause of death, but no therapy-related mortality associated with PBSCT was observed. The 5-year overall survival and progression-free survival were 70.6% (95% confidence interval [CI], 54.0-82.1) and 57.0% (95% CI, 39.5-71.2), respectively. Chronic renal impairment, therapy-related myelodysplastic syndrome and prostate cancer were the major late complications. The CEM regimen is a tolerable, effective conditioning regimen for autologous PBSCT for DLBCL, with no therapy-related mortality observed.
Department of Hematology and Rheumatology, Nihon University School of Medicine , Tokyo , Japan.
Yujin
Y
Kobayashi
Yoshihiro
Y
Hatta
Masahiko
M
Sugitani
Atsuko
A
Hojo
Masaru
M
Nakagawa
Machiko
M
Kusuda
Yoshihito
Y
Uchino
Hiromichi
H
Takahashi
Satomi
S
Kiso
Yukio
Y
Hirabayashi
Mai
M
Yagi
Hitomi
H
Kodaira
Daisuke
D
Kurita
Katsuhiro
K
Miura
Noriyoshi
N
Iriyama
Sumiko
S
Kobayashi
Yoshimasa
Y
Kura
Akira
A
Horikoshi
Umihiko
U
Sawada
Jin
J
Takeuchi
Masami
M
Takei
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009607:Nitrosourea Compounds / Q000008:administration & dosage; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
D009607:Nitrosourea Compounds; D005047:Etoposide; D003520:Cyclophosphamide; C020766:ranimustine
CEM regimen; Diffuse large B-cell lymphoma; autologous peripheral blood stem cell transplant; conditioning; follicular lymphoma; high-dose chemotherapy