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Sequential chemotherapy by CHOP and DHAP regimens followed by high-dose therapy with stem cell transplantation induces a high rate of complete response and improves event-free survival in mantle cell lymphoma: a prospective study

Leukemia volume 16, pages 587–593 (2002)Cite this article

Abstract

Mantle cell lymphoma (MCL) is a distinct clinico-pathological entity with a poor prognosis. We have conducted a prospective study in patients with MCL to evaluate a therapeutic strategy in which CHOP polychemotherapy was followed by DHAP if CHOP failed to induce complete remission. Responding patients then proceeded to an intensification therapy with autologous peripheral blood stem cell transplantation (APBSCT). Twenty-eight consecutive patients with newly diagnosed aggressive MCL were included. After four cycles of CHOP regimen, two complete responses (CR) were obtained (7%) and 14 (50%), five (18%) and seven (25%) patients achieved partial (PR), minor (MR) and no response, respectively (one patient died from septic complications during CHOP induction). The two patients in CR after CHOP underwent intensification with TBI, high-dose cyclophosphamide–etoposide and APBSCT. The other twenty-five patients received DHAP and in this group a response rate of 92% (21 CR (84%), two PR (8%)) was observed. Two patients had progressive disease. The twenty-three responding patients received high-dose therapy (TAM8 regimen: TBI–cytarabine–melphalan) followed by APBSCT. One of the two partial responding patients achieved CR after TAM8. After a median follow-up of 47.6 months (range, 14–70), seven patients have relapsed. Our data confirm that: (1) CHOP regimen induces a low CR rate in MCL; (2) CHOP plus DHAP appears to be much more efficient and allows a large proportion of patients to proceed to high-dose therapy in CR; (3) consolidation therapy including TBI and high-dose Arac-C followed by APBSCT may improve event-free survival.

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Authors and Affiliations

  1. Service d'Hématologie Adultes, Hôpital Necker, Paris, France

    F Lefrère, C Belanger, B Arnulf, G Damaj, N Maillard, B Varet & O Hermine

  2. Service des Maladies du Sang Hôpital de l'Hotel-Dieu, Paris, France

    A Delmer

  3. Service d'Onco-Hématologie, Hôpital André Mignot, Versailles, France

    F Suzan

  4. Département de Biostatistique Médicale, INSERM U444, Hôpital Saint-Louis, Paris, France

    V Levy

  5. Service d'Hématologie, Hôpital Cochin, Paris, France

    M Djabarri & F Dreyfus

  6. Institut Gustave Roussy, Villejuif, France

    V Ribrag

  7. Service d'Oncologie, Centre René Huguenin, St-Cloud, France

    M Janvier

  8. Service d'Hématologie, Hôpital Edouard Herriot, Lyon, France

    C Sebban

  9. Service d'Hématologie, Centre Hospitalier, Dijon, France

    R-O Casasnovas

  10. Service d'Hématologie, Institut Paoli-Calmette, Marseille, France

    R Bouabdallah

  11. Service d'Anatomopathologie, Hôpital Necker, Paris, France

    V Verkarre & N Brousse

  12. Laboratoire d'Hématologie, Hôpital Necker, Paris, France

    E Delabesse, F Valensi & E McIntyre

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  1. F Lefrère
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Lefrère, F., Delmer, A., Suzan, F. et al. Sequential chemotherapy by CHOP and DHAP regimens followed by high-dose therapy with stem cell transplantation induces a high rate of complete response and improves event-free survival in mantle cell lymphoma: a prospective study. Leukemia 16, 587–593 (2002). https://doi.org/10.1038/sj.leu.2402406

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