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High-dose sequential chemotherapy and in vivo rituximab-purged stem cell autografting in mantle cell lymphoma: a 10-year update of the R-HDS regimen

Bone Marrow Transplantation volume 43, pages 509–511 (2009)Cite this article

A possible limitation of these encouraging results is that they might reflect, as do the majority of phase II trials, a biased selection of younger and clinically fit patients, and/or they might include, by chance, predominantly low-risk MCL patients. However, the study enrolled a series of consecutive patients, with the expected distribution of the different prognostic categories (that is, 14 low-risk, 11 intermediate-risk and 2 high-risk patients according to their MIPI score).4

The R-HDS regimen appears to be a very effective dose-intense chemoimmunotherapy program for MCL. In particular, our data (10-year OS, 68% for intermediate/high-risk group, 76% for low-risk group; EFS, 34 and 57%, respectively) compare favorably with long-term reports from other groups who have used immunotherapy in association with dose-intense chemotherapy6 (hyper-CVAD; 5-year OS, 65%; EFS, 48%), even though a stratification based on MIPI score would have helped in the comparison of the results; in addition, they are in agreement with data obtained after a shorter (6-year) follow-up with a similar chemoimmunotherapy strategy.7 A direct comparison with data obtained in conventionally treated patients, as those reported recently by Determan et al.,8 is impossible for the short follow-up of these patients.

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Acknowledgements

We thank Mr Marco Milanesi and Mr Paolo Longoni for technical assistance; Dr Attilio Gabbas, Dr Roberto Crocchiolo and Dr Fabio Ciceri for referring patients with MCL.

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Authors and Affiliations

  1. Division of Medical Oncology 3, Istituto Nazionale Tumori, Milan, Italy

    M Magni, M Di Nicola, C Carlo-Stella, P Matteucci, L Devizzi & A M Gianni

  2. Chair of Oncology, University of Milan, Milan, Italy

    C Carlo-Stella & A M Gianni

  3. Department of Hematology, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy

    C Tarella

  4. Institute of Hematology, University of Verona, Verona, Italy

    F Benedetti

  5. Department of Cellular Biotechnology and Hematology, University La Sapienza, Rome, Italy

    M Martelli

  6. Division of Hematology, Ospedale Cervello, Palermo, Italy

    C Patti

  7. Division of Internal Medicine and Hematology, Ospedale San Luigi, Orbassano, Turin, Italy,

    G Parvis

  8. Division of Hematology, Ospedali Riuniti, Bergamo, Italy

    A Rambaldi & T Barbui

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Correspondence to M Magni.

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Magni, M., Di Nicola, M., Carlo-Stella, C. et al. High-dose sequential chemotherapy and in vivo rituximab-purged stem cell autografting in mantle cell lymphoma: a 10-year update of the R-HDS regimen. Bone Marrow Transplant 43, 509–511 (2009). https://doi.org/10.1038/bmt.2008.349

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