Mature results of the M. D. Anderson Cancer Center risk-adapted transplantation strategy in mantle cell lymphoma

In this study, we analyzed the long-term outcome of a risk-adapted transplantation strategy for mantle cell lymphoma in 121 patients enrolled in sequential transplantation protocols. Notable developments over the 17-year study period were the addition of rituximab to chemotherapy and preparative reg...

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Podrobná bibliografia
Vydané v:Blood Ročník 113; číslo 18; s. 4144
Hlavní autori: Tam, Constantine S, Bassett, Roland, Ledesma, Celina, Korbling, Martin, Alousi, Amin, Hosing, Chitra, Kebraei, Partow, Harrell, Robyn, Rondon, Gabriela, Giralt, Sergio A, Anderlini, Paolo, Popat, Uday, Pro, Barbara, Samuels, Barry, Hagemeister, Frederick, Medeiros, L Jeffrey, Champlin, Richard E, Khouri, Issa F
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 30.04.2009
Predmet:
Adult
Aged
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Combined Modality Therapy
Feasibility Studies
Female
Graft vs Host Disease - therapy
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, Mantle-Cell - mortality
Lymphoma, Mantle-Cell - therapy
Male
Middle Aged
Prognosis
Radiotherapy Dosage
Retrospective Studies
Risk Factors
Rituximab
Survival Rate
Transplantation Conditioning
Transplantation, Autologous
Treatment Outcome
ISSN:1528-0020, 1528-0020
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Shrnutí:In this study, we analyzed the long-term outcome of a risk-adapted transplantation strategy for mantle cell lymphoma in 121 patients enrolled in sequential transplantation protocols. Notable developments over the 17-year study period were the addition of rituximab to chemotherapy and preparative regimens and the advent of nonmyeloablative allogeneic stem cell transplantation (NST). In the autologous transplantation group (n = 86), rituximab resulted in a marked improvement in progression-free survival for patients who received a transplant in their first remission (where a plateau emerged at 3-8 years) but did not change the outcomes for patients who received a transplant beyond their first remission. In the NST group, composed entirely of patients who received a transplant beyond their first remission, durable remissions also emerged in progression-free survival at 5 to 9 years. The major determinants of disease control after NST were the use of a peripheral blood stem cell graft and donor chimerism of at least 95%, whereas the major determinant of death was immunosuppression for chronic graft-versus-host disease. Our results show that long-term disease-free survival in mantle cell lymphoma is possible after rituximab-containing autologous transplantation for patients in first remission and after NST for patients with relapsed or refractory disease.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1528-0020
1528-0020
DOI:10.1182/blood-2008-10-184200