Autologous hematopoietic stem cell transplantation for mantle cell lymphoma

This study evaluated the outcomes of patients who underwent high-dose chemo therapy (HDC) and autologous hematopoietic stem cell transplantation (autoH SCT) for mantle cell non-Hodgkin's lymphoma and the effect of clinical and treatment characteristics. The clinical outcome and prognostic factors in 4 0 patients who underwent HDC and autoHSCT for mantle cell lymphoma between June 1991 and Au,oust 1998 were analyzed. With a median follow-up of 24 mon ths for the surviving patients (range, 4-68 months), the 2-year overall sur vival was 65% and the 2-year event-fi ee survival (EFS) was 36%. In univari ate analysis, characteristics predictive of a poor EFS were blastic morphol ogy (P = .019) and the patient having received 3 or more prior chemotherapy regimens (P = .004). In a multivariate analysis, the only factor associate d with a poor EFS was the number of prior chemotherapy regimens. Those pati ents who received 3 or more prior therapies had a 2-year EFS of 0%, and tho se who received <3 therapies had a 2-year EFS of 45% (P = .004). Patients w ith mantle cell lymphoma can obtain prolonged EFS with HDC and autoHSCT; ho wever, this strategy for prolonged EFS appears to work optimally in patient s who are less heavily pretreated. Whether this therapy will increase the o verall survival or EFS in patients receiving transplants in first complete remission will need to be tested in prospective randomized clinical trials.