High-dose cyclophosphamide followed by autologous peripheral blood progenitor cell transplantation improves the salvage treatment for persistent or sensitive relapsed malignant lymphoma
Rev. bras. pesqui. méd. biol
; Braz. j. med. biol. res;35(1): 49-57, Jan. 2002. ilus, tab
Article
en En
| LILACS
| ID: lil-304193
Biblioteca responsable:
BR1.1
RESUMO
Trials have demonstrated that high-dose escalation followed by autologous transplantation can promote better long-term survival as salvage treatment in malignant lymphomas. The aim of the present nonrandomized clinical trial was to demonstrate the role of high-dose cyclophosphamide (HDCY) in reducing tumor burden and also to determine the effectiveness of HDCY followed by etoposide (VP-16) and methotrexate (MTX) in Hodgkin's disease plus high-dose therapy with peripheral blood progenitor cell (PBPC) transplantation as salvage treatment. From 1998 to 2000, 33 patients with a median age of 33 years (13-65) affected by aggressive non-Hodgkin's lymphoma (NHL) (60.6 percent) or persistent or relapsed Hodgkin's disease (39.4 percent) were enrolled and treated using high dose escalation (HDCY + HDVP-16 plus HDMTX in Hodgkin's disease) followed by autologous PBPC transplantation. On an "intention to treat" basis, 33 patients with malignant lymphomas were evaluated. The overall median follow-up was 400 days (40-1233). Thirty-one patients underwent autografting and received a median of 6.19 x 10(6)/kg (1.07-29.3) CD34+ cells. Patients who were chemosensitive to HDCY (N = 22) and patients who were chemoresistant (N = 11) presented an overall survival of 96 and 15 percent, respectively (P<0.0001). Overall survival was 92 percent for chemosensitive patients and 0 percent for patients who were still chemoresistant before transplantation (P<0.0001). Toxicity-related mortality was 12 percent (four patients), related to HDCY in two cases and to transplant in the other two. HDCY + HDVP-16 plus HDMTX in only Hodgkin's disease followed by autologous PBPC proved to be effective and safe as salvage treatment for chemosensitive patients affected by aggressive NHL and Hodgkin's disease, with acceptable mortality rates related to sequential treatment
Texto completo:
1
Colección:
01-internacional
Banco de datos:
LILACS
Asunto principal:
Linfoma no Hodgkin
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Enfermedad de Hodgkin
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Protocolos de Quimioterapia Combinada Antineoplásica
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Terapia Recuperativa
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Trasplante de Células Madre Hematopoyéticas
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Braz. j. med. biol. res
/
Rev. bras. pesqui. méd. biol
Asunto de la revista:
BIOLOGIA
/
MEDICINA
Año:
2002
Tipo del documento:
Article
País de afiliación:
Brasil