title: Autologous stem cell transplantation with in vivo purged progenitor cells shows long-term efficacy in relapsed/refractory follicular lymphoma.
abstract: High-dose chemotherapy with autologous stem cell transplantation (ASCT) has been shown effective in the control of relapsed/refractory follicular lymphoma. We evaluate the long-term outcome of patients with relapsed or refractory follicular lymphoma treated with ASCT with in vivo purged progenitors cells. We report the long-term results of a prospective multicenter phase 2 trial on 124 relapsed/refractory follicular lymphoma patients treated with a program of anthracycline-based debulking chemotherapy, immunochemotherapy, mobilization of in vivo purged PBSC followed by ASCT. Median age was 52 years; 14% of patients had grade 3A histology. Debulking chemotherapy produced CR in 16% and PR in 71%, while 13% of patients progressed. After rituximab, cyclophosphamide, vincristine, prednisone (R-COP), CR was obtained in 60% and PR in 35%; 118 patients successfully mobilized PBSC and 117 proceeded to ASCT. The harvest in all the 32 molecularly informative patients was bcl-2 negative. TRM was 0%. The 5-year PFS was 54% and the 5-year OS was 83%. After a median f-up of 6.7 years (range 1.5-13.6), 54% are still in CR. These data show that prolonged PFS is achievable in relapsed/refractory patients with high dose autologous transplantation of in vivo purged progenitor cells.
authors.affiliation: Department of Molecular Medicine, University of Pavia, Pavia, Italy; Department of Hematology and Oncology, Fondazione Istituto Di Ricovero E Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Arcaini
authors.forename: Lucia
authors.initials: L
authors.lastname: Morello
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tucci
authors.forename: Chiara
authors.initials: C
authors.lastname: Rusconi
authors.forename: Marco
authors.initials: M
authors.lastname: Ladetto
authors.forename: Sara
authors.initials: S
authors.lastname: Rattotti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bonfichi
authors.forename: Chiara
authors.initials: C
authors.lastname: Bottelli
authors.forename: Cristina
authors.initials: C
authors.lastname: Gabutti
authors.forename: Paolo
authors.initials: P
authors.lastname: Bernasconi
authors.forename: Marzia
authors.initials: M
authors.lastname: Varettoni
authors.forename: Manuel
authors.initials: M
authors.lastname: Gotti
authors.forename: Daniela
authors.initials: D
authors.lastname: Troletti
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Guerrera
authors.forename: Valeria
authors.initials: V
authors.lastname: Fiaccadori
authors.forename: Roberta
authors.initials: R
authors.lastname: Sciarra
authors.forename: Virginia Valeria
authors.initials: VV
authors.lastname: Ferretti
authors.forename: Emilio Paolo
authors.initials: EP
authors.lastname: Alessandrino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Enrica
authors.initials: E
authors.lastname: Morra
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D015870:Gene Expression; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011241:Prednisone / Q000008:administration & dosage; D011446:Prospective Studies; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000172:deficiency / Q000235:genetics; D012008:Recurrence; D000069283:Rituximab; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D018943:Anthracyclines; D058846:Antibodies, Monoclonal, Murine-Derived; C000595707:BCL2 protein, human; D019253:Proto-Oncogene Proteins c-bcl-2; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone