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Allografting

Pilot study of tandem high-dose chemotherapy and autologous stem cell transplantation with a novel combination of regimens in patients with poor risk lymphoma

Bone Marrow Transplantation volume 36, pages 491–497 (2005)Cite this article

Summary:

In an effort to improve the outcome of poor-risk lymphoma patients, we evaluated a novel regimen of tandem high-dose chemotherapy (THDC) with autologous stem cell transplantation. A total of 41 patients (median age 40 years, range 15–68 years) with poor-risk non-Hodgkin's lymphoma and Hodgkin's disease were enrolled. THDC consisted of melphalan (180 mg/m2) and escalating dose mitoxantrone (30–50 mg/m2) (MMt) for the first conditioning regimen, and thiotepa (500 mg/m2), carboplatin (800 mg/m2), and escalating dose etoposide phosphate (400–850 mg/m2), (ETCb) as the second regimen. In all, 31 patients (76%) completed both transplants, with a median time between transplants of 55 days (range 26–120). The maximum tolerated dose was determined as 40 mg/m2 for mitoxantrone and 550 mg/m2 for etoposide phosphate. The overall toxic death rate was 12%. Following high-dose chemotherapy, 10 of 24 evaluable patients (42%) were in CR. The two-year overall survival and event-free survival is 67% (95% CI, 52–81%) and 45%, (95% CI, 29–61%) for the 41 patients enrolled; and 69% (95% CI, 525–586%) and 48% (95% CI, 30–67%) for the 31 patients completing both transplants. This THDC regimen is feasible but with notable toxicity in heavily pretreated patients; its role in the current treatment of high-risk lymphoma remains to be determined.

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Acknowledgements

This work was supported in part by the Julie Gould Fund (KPP) and an unrestricted grant from Bristol Myers Squibb.

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Authors and Affiliations

  1. Institute for Drug Development, San Antonio, TX, USA

    K P Papadopoulos

  2. Division of Hematology/Medical Oncology, Columbia University, New York, NY, USA

    W Noguera-Irizarry, L Wiebe, C S Hesdorffer, G L Nichols, E Sharpe & D G Savage

  3. Department of Pediatric Oncology, Columbia University, New York, NY, USA

    J Garvin

  4. Division of Medical Oncology, Cornell University, New York, NY, USA

    L H Vahdat

  5. Bennett Cancer Center, Stamford, CT, USA

    K M S Lo

  6. Department of Transfusion Medicine, Columbia University, New York, NY, USA

    D Skerrett & D Bernstein

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  1. K P Papadopoulos
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Correspondence to D G Savage.

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Papadopoulos, K., Noguera-Irizarry, W., Wiebe, L. et al. Pilot study of tandem high-dose chemotherapy and autologous stem cell transplantation with a novel combination of regimens in patients with poor risk lymphoma. Bone Marrow Transplant 36, 491–497 (2005). https://doi.org/10.1038/sj.bmt.1705103

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