1. Autologous stem cell transplantation with in vivo purged progenitor cells shows long-term efficacy in relapsed/refractory follicular lymphoma
- Author
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Arcaini, Luca, Morello, Lucia, Tucci, Alessandra, Rusconi, Chiara, Ladetto, Marco, Rattotti, Sara, Bonfichi, Maurizio, Bottelli, Chiara, Gabutti, Cristina, Bernasconi, Paolo, Varettoni, Marzia, Gotti, Manuel, Troletti, Daniela, Guerrera, Maria Luisa, Fiaccadori, Valeria, Sciarra, Roberta, Ferretti, Virginia Valeria, Alessandrino, Emilio Paolo, Rossi, Giuseppe, and Morra, Enrica
- Subjects
Murine-Derived ,Adult ,Male ,Lymphoma ,Gene Expression ,Transplantation, Autologous ,Antibodies ,Aged ,Anthracyclines ,Antibodies, Monoclonal, Murine-Derived ,Cyclophosphamide ,Female ,Hematopoietic Stem Cell Mobilization ,Humans ,Lymphoma, Follicular ,Middle Aged ,Neoplasm Grading ,Prednisone ,Prospective Studies ,Proto-Oncogene Proteins c-bcl-2 ,Recurrence ,Rituximab ,Survival Analysis ,Treatment Outcome ,Vincristine ,Antineoplastic Combined Chemotherapy Protocols ,Hematopoietic Stem Cell Transplantation ,Hematology ,Monoclonal ,Transplantation ,Follicular ,Autologous - 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.
- Published
- 2014