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Non-Hodgkin's Lymphoma

Autologous stem cell transplantation for non-Hodgkin's lymphoma: comparison of radiation-based and chemotherapy-only preparative regimens

Bone Marrow Transplantation volume 28, pages 455–461 (2001)Cite this article

Abstract

The aim of this study was to compare toxicity and efficacy of total body irradiation (TBI), cyclophosphamide (CY) and etoposide (E) (TBI/CY/E) vs busulfan, melphalan and thiotepa (Bu/Mel/T) in patients receiving autologous stem cell infusion (ASCI) for malignant lymphoma (NHL). Between September 1990 and July 1998, 351 patients with NHL were treated with TBI/CY/E (n = 221) or Bu/Mel/T (n = 130) followed by ASCI. Patients in first, or second remission, first responding or untreated relapse were defined as having less advanced disease before transplantation. The median follow-up was 5 years (range 1–9) and 3.5 years (1–6) for patients receiving TBI/CY/E and Bu/Mel/T, respectively. The cumulative probabilities of survival, event-free survival (EFS) and relapse at 5 years were 44%, 32%, 49% following TBI/CY/E and 42%, 34% and 42% following Bu/Mel/T. The probability of EFS at 5 years for patients who had prior dose-limiting radiation (n = 59) was 32% after Bu/Mel/T therapy. Transplant-related mortality was 16% for TBI/CY/E and 21% for Bu/Mel/T. In univariate and multivariate analyses, more advanced disease status was associated with poor outcome (TBI/CY/E: RR 0.70, CI 0.50 to 0.97 P = 0.04; Bu/Mel/T: RR 0.61, CI 0.39 to 0.97 P = 0.03). No significant differences in toxicities and outcomes were observed between these two regimens despite the inclusion of patients who had received dose-limiting irradiation in the Bu/Mel/T regimen. Bone Marrow Transplantation (2001) 28, 455–461.

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Acknowledgements

This work was supported by grants from the National Institutes of Health CA 18029, CA 47748, CA 15704 and the Jose Carreras Foundation Against Leukemia. FG-D was supported by grants from Instituto Mexicano del Seguro Social (IMSS) and Consejo Nacional de Ciencia y Tecnologia (CONACYT), Mexico City, Mexico.

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Authors and Affiliations

  1. The Fred Hutchinson Cancer Research, Seattle, WA, USA

    F Gutierrez-Delgado, DG Maloney, OW Press, J Golden, LA Holmberg, H Hooper, CD Buckner, FR Appelbaum & WI Bensinger

  2. University of Washington, Seattle, WA, USA

    DG Maloney, OW Press, J Golden, LA Holmberg, CD Buckner, FR Appelbaum & WI Bensinger

  3. Puget Sound Oncology Consortium, Seattle, WA, USA

    RT Maziarz

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Gutierrez-Delgado, F., Maloney, D., Press, O. et al. Autologous stem cell transplantation for non-Hodgkin's lymphoma: comparison of radiation-based and chemotherapy-only preparative regimens. Bone Marrow Transplant 28, 455–461 (2001). https://doi.org/10.1038/sj.bmt.1703179

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