Clinical outcome after autologous transplantation in non-Hodgkin's lymphoma patients with high international prognostic index (IPI)

Citation
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
Citations number
26
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
ANNALS OF ONCOLOGY
ISSN journal
09237534 → ACNP
Volume
10
Issue
4
Year of publication
1999
Pages
427 - 432
Database
ISI
SICI code
0923-7534(199904)10:4<427:COAATI>2.0.ZU;2-E
Abstract
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.