ABSTRACT
BACKGROUND: Long-term clinical and molecular remissions in patients with follicular lymphoma (FL) following high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) have been evaluated in only a few studies. Results are especially limited for second-line HDT with BEAM (BCNU, etoposide, cytarabine and melphalan). PATIENTS AND METHODS: Sixty patients with FL received ASCT in our institution (18 first-line with total body irradiation and cyclophosphamide, 34 second-line with BEAM and 8 ≥ third-line with BEAM). In the case of long-term remission (>6 years; N = 17), peripheral blood was tested for minimal residual disease by t(14;18)- and IGH-PCR. RESULTS: Ten-year overall survival, progression-free survival and freedom from progression (FFP) after first-line ASCT were 79%, 57% and 64% after second-line ASCT 41%, 35% and 42%, respectively. Prognostic factors for FFP were treatment line and FLIPI (Follicular Lymphoma International Prognostic Index). Ten-year FFP for second-line ASCT and low-risk FLIPI was 57%, intermediate risk 37% and high risk 33%. No relapses occurred after 6 years following ASCT. Sixteen patients developed sustained long-term clinical and molecular remissions of up to 17.5 years. CONCLUSION: Sustained long-term clinical and molecular remissions can be achieved following ASCT, including HDT with BEAM in second line.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Lymphoma, Follicular/drug therapy , Lymphoma, Follicular/surgery , Stem Cell Transplantation/methods , Adult , Aged , Carmustine/administration & dosage , Cohort Studies , Combined Modality Therapy/methods , Combined Modality Therapy/mortality , Cytarabine/administration & dosage , Disease-Free Survival , Female , Follow-Up Studies , Humans , Lymphoma, Follicular/mortality , Male , Melphalan/administration & dosage , Middle Aged , Podophyllotoxin/administration & dosage , Remission Induction/methods , Stem Cell Transplantation/mortality , Time Factors , Transplantation, Autologous , Treatment OutcomeSubject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Small Cell/drug therapy , Cisplatin/therapeutic use , Lung Neoplasms/drug therapy , Antineoplastic Agents/administration & dosage , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Agents, Phytogenic/therapeutic use , Carcinoma, Small Cell/mortality , Cisplatin/administration & dosage , Data Interpretation, Statistical , Etoposide/administration & dosage , Etoposide/therapeutic use , Female , Humans , Lung Neoplasms/mortality , Male , Quality of Life , Retrospective Studies , Time FactorsABSTRACT
Patients with inoperable head and neck cancer were treated with a spleen peptide preparation (Polyerga) in a phase III randomized, placebo-controlled double-blind study during chemotherapy (cisplatin/carboplatin, 5-fluorouracil) to investigate further the efficacy of this peptide preparation as supportive treatment under chemotherapy. Immunological changes as well as quality of life aspects were examined. Forty patients were included in this study. The peptide preparation had a significant stabilizing effect on the peripheral blood lymphocyte status during chemotherapy cycles (Student t-test, p = 0.05) and tended to stabilize the shift of granulocyte count (Student t-test, p = 0.18). In addition, the group receiving the verum showed a remarkable stabilization of body weight (Mann-Whitney U-test, p = 0.17) during chemotherapy treatment and the generally observed increase of fatigue-inertia during the chemotherapy cycles was significantly reduced (Student t-test, p = 0.01).
