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Long-term outcomes after thiotepa-based high-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) in non-Hodgkin lymphoma (NHL)

Bone Marrow Transplantation volume 52, pages 321–322 (2017)Cite this article

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Autologous hematopoietic cell transplantation (auto-HCT) is considered the standard approach for relapsed or refractory non-Hodgkin lymphoma (NHL).1 The therapeutic rationale for auto-HCT is the delivery of myeloablative doses of chemotherapy and/or radiation without overlapping toxicities, thus increasing the response of the resistant lymphoma cells. Relapse/progression of lymphoma and to a lesser extent non-relapse mortality (NRM) remain limitations to treatment success. Although several conditioning regimens are available, including the commonly utilized BEAM (carmustine, etoposide, cytarabine, melphalan)2 and CBV (cyclophosphamide, carmustine, etoposide),3 there is no general consensus regarding a standard conditioning approach in lymphoproliferative disorders.

Thiotepa is an alkylating agent with potent anti-lymphoma properties, making it an attractive agent for high-dose chemotherapy and auto-HCT. Thiotepa was originally used as part of preparative regimens for solid tumor malignancies, such as breast and ovarian cancer.4 Owing to thiotepa’s excellent central nervous system (CNS) penetration, it has increasingly been evaluated in CNS malignancies, including lymphoma.5, 6, 7 Several thiotepa-based regimens, typically combined with etoposide,8, 9, 10, 11 carboplatin,9, 11, 12, 13 mitoxantrone,11, 12 busulfan11, 14, 15 or melphalan,11, 13, 14, 15 have shown activity in lymphoma patients with or without CNS involvement. To our knowledge, there are no reports of the specific combination of thiotepa, etoposide and cyclophosphamide (VP/Cy/TT) as a conditioning regimen for NHLs. Here we report the long-term outcomes with this conditioning regimen for auto-HCT in patients with NHL.

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Author notes

  1. N Shah and S Rauenzahn: These authors contributed equally to this work.

Authors and Affiliations

  1. Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, WV, USA

    N Shah, L Veltri, M Craig, A S Kanate & A Cumpston

  2. Department of Internal Medicine, West Virginia University, Morgantown, WV, USA

    S Rauenzahn

  3. Department of Biostatistics, West Virginia University, Morgantown, WV, USA

    S Wen

  4. Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

    M Hamadani

  5. Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA

    A Cumpston

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  1. N Shah
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Correspondence to A Cumpston.

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Shah, N., Rauenzahn, S., Veltri, L. et al. Long-term outcomes after thiotepa-based high-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) in non-Hodgkin lymphoma (NHL). Bone Marrow Transplant 52, 321–322 (2017). https://doi.org/10.1038/bmt.2016.275

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