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Bone Marrow Transplant ; 36(6): 491-7, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16044139

ABSTRACT

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.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Hematopoietic Stem Cell Transplantation/methods , Lymphoma/therapy , Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/toxicity , Female , Hematopoietic Stem Cell Transplantation/mortality , Humans , Lymphoma/complications , Lymphoma/mortality , Male , Maximum Tolerated Dose , Melphalan/administration & dosage , Middle Aged , Mitoxantrone/administration & dosage , Pilot Projects , Risk , Survival Analysis , Transplantation Conditioning/methods , Transplantation, Autologous
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