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Autografting

Long-term progression-free survival after early autologous transplantation for mantle-cell lymphoma

Abstract

Autologous hematopoietic progenitor SCT (HPCT) has been studied both as a consolidative and salvage maneuver in mantle-cell lymphoma (MCL), and may improve failure-free survival rates as well as overall survival. We describe 21 patients with MCL who received autologous HPCT at Emory University Hospital as part of the primary treatment strategy. Sixteen patients were in CR1 and five in PR1 at the time of HPCT. The most commonly used induction chemotherapy was the hyper-CVAD (cyclophosphamide, vincristine, doxorubicin and dexamethasone) regimen with or without rituximab. At the last follow-up, 17 patients were in continuous CR, and there were four relapses. There were no transplant-related deaths. With a median follow-up of 54 months from HPCT, 5-year progression-free survival and overall survival are 73% and 76%, respectively. Our retrospective analysis provides the longest follow-up to date for patients with MCL who received an autologous HPCT as part of primary treatment. This lengthy follow-up helps define the natural course of MCL after autologous transplantation.

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References

  1. Banks PM, Chan J, Cleary ML, Delsol G, De Wolf-Peeters C, Gatter K et al. Mantle cell lymphoma. A proposal for unification of morphologic, immunologic, and molecular data. Am J Surg Pathol 1992; 16: 637–640.

    Article  CAS  PubMed  Google Scholar 

  2. Lenz G, Dreyling M, Hoster E, Wormann B, Duhrsen U, Metzner B et al. Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2005; 23: 1984–1992.

    Article  CAS  PubMed  Google Scholar 

  3. Hess G, Flohr T, Huber C, Kolbe K, Derigs HG, Fischer T . Safety and feasibility of CHOP/rituximab induction treatment followed by high-dose chemo/radiotherapy and autologous PBSC-transplantation in patients with previously untreated mantle cell or indolent B-cell-non-Hodgkin′s lymphoma. Bone Marrow Transplant 2003; 31: 775–782.

    Article  CAS  PubMed  Google Scholar 

  4. Howard OM, Gribben JG, Neuberg DS, Grossbard M, Poor C, Janicek MJ et al. Rituximab and CHOP induction therapy for newly diagnosed mantle-cell lymphoma: molecular complete responses are not predictive of progression-free survival. J Clin Oncol 2002; 20: 1288–1294.

    Article  CAS  PubMed  Google Scholar 

  5. Khouri IF, Romaguera J, Kantarjian H, Palmer JL, Pugh WC, Korbling M et al. Hyper-CVAD and high-dose methotrexate/cytarabine followed by stem-cell transplantation: an active regimen for aggressive mantle-cell lymphoma. J Clin Oncol 1998; 16: 3803–3809.

    Article  CAS  PubMed  Google Scholar 

  6. Ritchie DS, Seymour JF, Grigg AP, Roberts AW, Hoyt R, Thompson S et al. The hyper-CVAD-rituximab chemotherapy programme followed by high-dose busulfan, melphalan and autologous stem cell transplantation produces excellent event-free survival in patients with previously untreated mantle cell lymphoma. Ann Hematol 2007; 86: 101–105.

    Article  CAS  PubMed  Google Scholar 

  7. Romaguera JE, Fayad L, Rodriguez MA, Broglio KR, Hagemeister FB, Pro B et al. High rate of durable remissions after treatment of newly diagnosed aggressive mantle-cell lymphoma with rituximab plus hyper-CVAD alternating with rituximab plus high-dose methotrexate and cytarabine. J Clin Oncol 2005; 23: 7013–7023.

    Article  CAS  PubMed  Google Scholar 

  8. Epner E, Unger J, Miller T, Rimzsa L, Spier C, Leblanc M . A multi center trial of hyperCVAD+Rituxan in patients with newly diagnosed mantle cell lymphoma. Blood 2007; 110 (abstract 38).

  9. Andersen NS, Pedersen L, Elonen E, Johnson A, Kolstad A, Franssila K et al. Primary treatment with autologous stem cell transplantation in mantle cell lymphoma: outcome related to remission pretransplant. Eur J Haematol 2003; 71: 73–80.

    Article  PubMed  Google Scholar 

  10. Decaudin D, Brousse N, Brice P, Haioun C, Bourhis JH, Morel P et al. Efficacy of autologous stem cell transplantation in mantle cell lymphoma: a 3-year follow-up study. Bone Marrow Transplant 2000; 25: 251–256.

    Article  CAS  PubMed  Google Scholar 

  11. Vandenberghe E, Ruiz de Elvira C, Loberiza FR, Conde E, Lopez-Guillermo A, Gisselbrecht C et al. Outcome of autologous transplantation for mantle cell lymphoma: a study by the European Blood and Bone Marrow Transplant and Autologous Blood and Marrow Transplant Registries. Br J Haematol 2003; 120: 793–800.

    Article  PubMed  Google Scholar 

  12. Dreger P, Martin S, Kuse R, Sonnen R, Glass B, Kroger N et al. The impact of autologous stem cell transplantation on the prognosis of mantle cell lymphoma: a joint analysis of two prospective studies with 46 patients. Hematol J 2000; 1: 87–94.

    Article  CAS  PubMed  Google Scholar 

  13. Kasamon YL, Jones RJ, Diehl LF, Nayer H, Borowitz MJ, Garrett-Mayer E et al. Outcomes of autologous and allogeneic blood or marrow transplantation for mantle cell lymphoma. Biol Blood Marrow Transplant 2005; 11: 39–46.

    Article  PubMed  Google Scholar 

  14. Khouri IF, Lee MS, Saliba RM, Jun G, Fayad L, Younes A et al. Nonablative allogeneic stem cell transplantation for advanced/recurrent mantle-cell lymphoma. J Clin Oncol 2003; 21: 4407–4412.

    Article  CAS  PubMed  Google Scholar 

  15. Mangel J, Leitch HA, Connors JM, Buckstein R, Imrie K, Spaner D et al. Intensive chemotherapy and autologous stem cell transplantation plus rituximab is superior to conventional chemotherapy for newly diagnosed advanced stage mantle-cell lymphoma: a matched pair analysis. Ann Oncol 2004; 15: 283–290.

    Article  CAS  PubMed  Google Scholar 

  16. Milpied N, Gaillard F, Moreau P, Mahe B, Souchet J, Rapp MJ et al. High-dose therapy with stem cell transplantation for mantle cell lymphoma: results and prognostic factors, a single center experience. Bone Marrow Transplant 1998; 22: 645–650.

    Article  CAS  PubMed  Google Scholar 

  17. Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17: 1244.

    Article  CAS  PubMed  Google Scholar 

  18. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25: 579–586.

    Article  PubMed  Google Scholar 

  19. Sacher R, Aubuchon J . Marrow Transplantation: Practical and Technical Aspects of Stem Cell Reconstitution. Amer Assn of Blood Banks, Bethesda, MD, 1992.

    Google Scholar 

  20. Khouri IF, Saliba RM, Okoroji GJ, Acholonu SA, Champlin RE . Long-term follow-up of autologous stem cell transplantation in patients with diffuse mantle cell lymphoma in first disease remission: the prognostic value of beta2-microglobulin and the tumor score. Cancer 2003; 98: 2630–2635.

    Article  PubMed  Google Scholar 

  21. Dreyling M, Lenz G, Hoster E, Van Hoof A, Gisselbrecht C, Schmits R et al. Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network. Blood 2005; 105: 2677–2684.

    Article  CAS  PubMed  Google Scholar 

  22. Schulz H, Bohlius JF, Trelle S, Skoetz N, Reiser M, Kober T et al. Immunochemotherapy with rituximab and overall survival in patients with indolent or mantle cell lymphoma: a systematic review and meta-analysis. J Natl Cancer Inst 2007; 99: 706–714.

    Article  CAS  PubMed  Google Scholar 

  23. Vose J, Loberiza F, Bierman B, Bociek G, Armitage J . Mantle cell lymphoma (MCL): Induction therapy with HyperCVAD/High-dose methotrexate and cytarabine (M-C) (±rituximab) improves results of autologous stem cell transplant in first remission. Journal of Clinical Oncology 2006 ASCO Annual Meeting Proceedings Part I Vol 24, No 18S (June 20 Supplement), 2006: 7511. 2007.

  24. Vigouroux S, Gaillard F, Moreau P, Harousseau JL, Milpied N . High-dose therapy with autologous stem cell transplantation in first response in mantle cell lymphoma. Haematologica 2005; 90: 1580–1582.

    CAS  PubMed  Google Scholar 

  25. Laudi N, Arora M, Burns L, McGlave P, Miller J, Bohac G et al. Efficacy of high-dose therapy and hematopoietic stem cell transplantation for mantle cell lymphoma. Am J Hematol 2006; 81: 519–524.

    Article  PubMed  Google Scholar 

  26. Martinez C, Carreras E, Rovira M, Urbano-Ispizua A, Esteve J, Perales M et al. Patients with mantle-cell lymphoma relapsing after autologous stem cell transplantation may be rescued by allogeneic transplantation. Bone Marrow Transplant 2000; 26: 677–679.

    Article  CAS  PubMed  Google Scholar 

  27. Hoogendoorn M, Olde Wolbers J, Smit WM, Schaafsma MR, Jedema I, Barge RM et al. Primary allogeneic T-cell responses against mantle cell lymphoma antigen-presenting cells for adoptive immunotherapy after stem cell transplantation. Clin Cancer Res 2005; 11: 5310–5318.

    Article  CAS  PubMed  Google Scholar 

  28. Khouri IF, Lee MS, Romaguera J, Mirza N, Kantarjian H, Korbling M et al. Allogeneic hematopoietic transplantation for mantle-cell lymphoma: molecular remissions and evidence of graft-versus-malignancy. Ann Oncol 1999; 10: 1293–1299.

    Article  CAS  PubMed  Google Scholar 

  29. Maris MB, Sandmaier BM, Storer BE, Chauncey T, Stuart MJ, Maziarz RT et al. Allogeneic hematopoietic cell transplantation after fludarabine and 2 Gy total body irradiation for relapsed and refractory mantle cell lymphoma. Blood 2004; 104: 3535–3542.

    Article  CAS  PubMed  Google Scholar 

  30. Russell NH, Byrne JL, Faulkner RD, Gilyead M, Das-Gupta EP, Haynes AP . Donor lymphocyte infusions can result in sustained remissions in patients with residual or relapsed lymphoid malignancy following allogeneic haemopoietic stem cell transplantation. Bone Marrow Transplant 2005; 36: 437–441.

    Article  CAS  PubMed  Google Scholar 

  31. Smith M, Zhang L, Gordon L, Foran J, Kahl B, Gascoyne R et al. Phase II Study of R-CHOP Followed by 90Y-Ibritumomab Tiuxetan in Untreated Mantle Cell Lymphoma: Eastern Cooperative Oncology Group Study E1499. Blood 2007; 110: 389.

    Google Scholar 

  32. Thieblemont C, Antal D, Lacotte-Thierry L, Delwail V, Espinouse D, Michallet AS et al. Chemotherapy with rituximab followed by high-dose therapy and autologous stem cell transplantation in patients with mantle cell lymphoma. Cancer 2005; 104: 1434–1441.

    Article  CAS  PubMed  Google Scholar 

  33. Gianni AM, Magni M, Martelli M, Di Nicola M, Carlo-Stella C, Pilotti S et al. Long-term remission in mantle cell lymphoma following high-dose sequential chemotherapy and in vivo rituximab-purged stem cell autografting (R-HDS regimen). Blood 2003; 102: 749–755.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank the physicians, nurses and ancillary staff at Emory University Hospital and the Winship Cancer Institute for providing outstanding care in the in-patient and outpatient settings. We are also extremely grateful to the patients and their families and are honored to have been involved in their care.

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Correspondence to S Murali.

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Murali, S., Winton, E., Waller, E. et al. Long-term progression-free survival after early autologous transplantation for mantle-cell lymphoma. Bone Marrow Transplant 42, 529–534 (2008). https://doi.org/10.1038/bmt.2008.201

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