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Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma

Bone Marrow Transplantation volume 50, pages 301–303 (2015)Cite this article

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High-dose chemotherapy (HDC) followed by autologous peripheral blood stem cell transplantation (HDC-auto-PBSCT) offers a cure for patients with lymphoma without the risk of GVHD. Conditioning regimens for Auto-SCT administered to patients in major studies have included BCNU in the BEAM or BEAC (BCNU, etoposide, cytarabine and cyclophosphamide) regimens.1 However, BCNU is not available in Japan; therefore, various alternative regimens using ranimustine (MCNU) have been developed. An HDC regimen with MCNU, carboplatin, etoposide and cyclophosphamide (MCEC), which was first published by the Fukuoka Bone Marrow Transplantation Group,2 has been widely used as a conditioning regimen for auto-PBSCT for non-Hodgkin lymphoma in Japan.3, 4, 5 Multicenter trials have published the outcomes of the MCEC regimen, but only limited information is available with regard to prognostic factors (particularly laboratory parameters) for HDC-auto-PBSCT with the MCEC regimen.4,5 Therefore, to establish predictive models for selecting appropriate therapeutic strategies, we retrospectively evaluated pre-transplantation factors that correlate with post-transplantation survival among patients with non-Hodgkin lymphoma who received first auto-PBSCT with the MCEC regimen as a historical cohort study.

Patients who had received the MCEC regimen, which consisted of MCNU 200 mg/m2 on days −8 and −3, carboplatin 300 mg/m2 from days −7 to −4, etoposide 500 mg/m2 from days −6 to −4 and cyclophosphamide 60 mg/kg on days −3 and −2, as arranged of which was described previously,2,3 between August 1999 and December 2012 at Showa University Hospital, were enrolled. Responses to first-line chemotherapy, prior to chemotherapy of HDC-auto-PBSCT, and HDC-auto-PBSCT themselves were judged according to the International Working Group response criteria without evaluation using positron emission tomography-computed tomography findings.6 The responses to prior chemotherapies of HDC-auto-PBSCT were defined as disease status at SCT (CR as CR or CR/unconfirmed [CRu]; non-CR as less than CRu) and chemosensitivity at SCT (chemosensitive as CR, CRu or PR; chemoresistant as less than PR). Pre-transplantation factors, the prognostic impacts of most of which have been reported previously, were evaluated using univariate and multivariate analyses. The factors included laboratory parameters before HDC-auto-PBSCT, which were defined as the values determined between the latest chemotherapy end date and the administration of MCEC conditioning. All P values were determined from 2-tailed tests, with P<0.05 considered significant. All statistical analyses were performed using EZR version 1.24 (Kanda Y, Saitama Medical Center, Jichi Medical University, Saitama, Japan). The study protocol was approved by the Ethics Committee of Showa University (Tokyo, Japan), which adhered to the principles of the Declaration of Helsinki.

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan

    H Ariizumi, B Saito, Y Uto, N Hattori, H Nakashima, K Yanagisawa, H Harada, H Mori & T Nakamaki

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  1. H Ariizumi
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Correspondence to H Ariizumi.

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Ariizumi, H., Saito, B., Uto, Y. et al. Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma. Bone Marrow Transplant 50, 301–303 (2015). https://doi.org/10.1038/bmt.2014.236

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