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Consolidation Therapy Following Autologous Stem Cell Transplantation For Non-Hodgkins And Hodgkins Lymphomas

Year: 2010

Type: article

Abstract: To determine whether autologous stem-cell transplantation (ASCT) followed by consolidation with Rituximab or irradiation is superior to ASCT alone in adults with advanced or relapsed lymphoma. Fourteen consecutive lymphoma patients were entered onto this prospective, single center, phase II study. Seventeen previously transplanted patients were used as historical controls with continuous follow-up. Patients with non-Hodgkin's lymphoma (NHL, n=11) or Hodgkin's disease (HD, n=3) received ASCT followed by consolidation with Rituximab (375 mg/m2/week x4, every 6 months x5) or irradiation (20-30 Gy) respectively. Age, diagnosis (NHL vs. HD), B symptoms, risk factors, LDH, previous treatment response and histological type were well balanced between the two groups. With a median follow-up of 21.3 months, the 30-month relapse rate was 23% and 53% (P=0.045), disease-free survival was 70% and 41% (P=0.03) and overall survival was 73% and 47% (P=0.07) for the consolidation group and historical controls, respectively. A multivariate analysis showed that age≥55 and abnormal pre-transplant LDH were predictors of poor outcome. When NHL patients were analyzed separately (n=24), 30-month relapse rate was 27% and 63% (P=0.08), disease free survival was 73% and 47% (P=0.05) and overall survival was 70% and 40% (P=0.06) for consolidation and control arms, respectively. The use of ASCT followed by consolidation using Rituximab (NHL) or irradiation (HD) in adults with advanced lymphoma showed a markedly decreased relapse rate and improved disease free and overall survival compared with conventional ASCT. The NHL subgroup (Rituximab) also demonstrated that consolidation produced a marked advantage.

Source: Transplantation and Cellular Therapy

DOI: 10.1016/j.bbmt.2009.12.168

Authors: G.A. Colvin, C. Milani, D. Berz, P. Quesenberry

Institution: Brown University

Language: English

Topic: Lymphoma Diagnosis and Treatment

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,650