High rate of clinical and molecular remissions in follicular lymphoma patients receiving high-dose sequential chemotherapy and autografting at diagnosis: A multicenter, prospective study by the Gruppo Italiano Trapianto Midollo Osseo (GITMO)

Marco Ladetto*, Paolo Corradini, Sonia Vallet, Fabio Benedetti, Umberto Vitolo, Maurizio Martelli, Maura Brugiatelli, Paolo Coser, Alessio Perrotti, Ignazio Majolino, Giuseppe Fioritoni, Sergio Morandi, Maurizio Musso, Renato Zambello, Teodora Chisesi, Nicola Di Renzo, Paolo Vivaldi, Alberto De Crescenzo, Andrea Gallamini, Flavia SalviGino Santini, Carola Boccomini, Marco Sorio, Monica Astolfi, Daniela Drandi, Alessandro Pileri, Corrado Tarella

*Korrespondierende:r Autor:in für diese Arbeit

Publikation: Beitrag in Fachzeitschrift (peer-reviewed)Artikel in Fachzeitschrift

101 Zitate (Scopus)

Abstract

Single-center experiences have shown that intensified treatments with autologous transplantation are a promising therapeutic strategy for patients with high-risk follicle-center lymphoma (FCL) at diagnosis, whereas data from prospective multicenter trials are still lacking. This paper describes the results of a prospective multicenter study of an intensified purging-free high-dose sequential (i-HDS) chemotherapy schedule with peripheral blood progenitor cell (PBPC) autografting. The main feature of this program is harvesting stem cells after intensified chemotherapeutic debulking, with no ex vivo manipulation of PBPCs. Ninety-two previously untreated patients aged 60 or younger with advanced-stage FCL were enrolled by 20 Italian centers and evaluated on an intention-to-treat basis. i-HDS proved feasible with limited toxicity (87% patients completed the planned treatment schedule). i-HDS led to a complete remission rate of 88%. The projected overall survival and disease-free survival (DFS) were, respectively, 84% and 67% at 4 years. Centralized molecular analysis showed that polymerase chain reaction-negative harvests could be collected in 47% of cases. Following autograft, 65% of molecularly evaluable patients achieved clinical and molecular remission. The projected DFS at 4 years of this subgroup is 85%. This result emphasizes the importance of achieving maximal tumor reduction in these patients. In conclusion, our data show that highly effective intensified treatments can now be routinely offered to young patients with poor-risk FCL even at small institutions, with no need for sophisticated and expensive cell manipulation procedures.

OriginalspracheEnglisch
Seiten (von - bis)1559-1565
Seitenumfang7
FachzeitschriftBlood
Jahrgang100
Ausgabenummer5
DOIs
PublikationsstatusVeröffentlicht - 01 Sept. 2002
Extern publiziertJa

ASJC Scopus Sachgebiete

  • Biochemie
  • Immunologie
  • Hämatologie
  • Zellbiologie

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