S. Cortelazzo et al., Clinical outcome after autologous transplantation in non-Hodgkin's lymphoma patients with high international prognostic index (IPI), ANN ONCOL, 10(4), 1999, pp. 427-432
Background: Dose intensification and autologous stem cell transplantation a
s front-line therapy in non-Hodgkin's lymphoma patients (NHL) is a matter f
or debate, although preliminary data suggest a role for it in patients at h
igh risk of resistance or relapse according to the international prognostic
index (IPI).
Purpose and study design: To compare retrospectively the clinical outcome o
f two cohorts of NHL patients with highrisk IPI treated with MACOP-B for 12
weeks (38 patients) or high-dose chemotherapy (44 patients) including eigh
t weeks of MACOP-B, one or two intensification cycles with mitoxanthrone, d
examethasone, high-dose ara-C and finally BEAM chemotherapy with autologous
hemopoietic progenitor cell transplantation.
Results: The actuarial estimate of event (progression, relapse or death)-fr
ee survival (EFS) at three years was better (58% vs. 41%, P = 0.08) for pat
ients treated with the intensive regimen even though the overall survival d
id not show a statistically significant difference (63% vs. 50%, P = 0.27).
Multivariate analysis showed that the high-dose chemotherapy program was t
he only independent variable correlating with a reduction in the event rate
.
Conclusion: Early autologous stem-cell transplantation might improve the cl
inical outcome of high-risk patients according to IPI.