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Non-Hodgkin's Lymphoma

Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens

Bone Marrow Transplantation volume 27, pages 405–412 (2001)Cite this article

Abstract

We investigated the impact of the most commonly used preparative regimens on the outcome of 395 patients with diffuse large cell lymphoma (DLCL), consecutively reported to the registry of the Spanish GEL/TAMO. Among them, 139 (35%) were autografted in 1st CR, 86 (22%) in 2nd/3rd CR, 124 (31%) had chemosensitive disease and 46 (12%) had chemoresistant disease. Conditioning consisted of chemotherapy-only in 348 patients (BEAM, 164; BEAC, 145; and CBV, 39) and radiochemotherapy with CY and TBI in 47. Median times to granulocyte, platelet recovery and to discharge were significantly shorter in the chemotherapy-only group. Early transplant-related mortality was significantly higher when using CY-TBI. After a median follow-up of 28 months, overall survival (OS) at 8 years of patients conditioned with BEAM or BEAC (58% (95% CI 50–66%)) was more favorable than with CBV (40% (95% CI 24–56%)), and significantly better than with CY-TBI (31% (95% CI 18–44%)). Multivariate analysis revealed that patients conditioned with chemotherapy-only regimens had improved OS, disease-free (DFS) and relapse-free survival (RFS) when compared to those conditioned with CY-TBI. Status at transplant was also a powerful prognostic indicator. We conclude that preparative regimens consisting of chemotherapy-only seem more efficacious than CY-TBI as conditioning for DLCL, because of faster engraftment and greater anti-lymphoma effect, as indicated by improved OS, DFS and RFS. Bone Marrow Transplantation (2001) 27, 405–412.

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Authors and Affiliations

  1. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    A Salar & J Sierra

  2. Hospital Marqués de Valdecilla, Santander, Spain

    M Gandarillas & E Conde

  3. Hospital Clínico de Salamanca, Spain

    MD Caballero

  4. Hospital Nuestra Señora de Aranzazu, San Sebastián, Spain

    J Marín

  5. Hospital 12 de Octubre, Madrid, Spain

    JJ Lahuerta

  6. Hospital Clínico de Valencia, Spain

    J García-Conde

  7. Hospital de la Princesa, Madrid, Spain

    R Arranz

  8. Hospital General de Jerez, Cádiz, Spain

    A León

  9. Hospital Vall d'Hebron, Barcelona, Spain

    J Zuazu

  10. Hospital Ramón y Cajal, Madrid, Spain

    J García-Laraña

  11. Hospital Clínic de Barcelona, Spain

    A López-Guillermo

  12. Hospital La Fe, Valencia, Spain

    MA Sanz

  13. Institut Català d'Oncologia, Barcelona, Spain

    A Grañena

  14. Hospital de Cruces, Vizcaya, Spain

    JC García

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Salar, A., Sierra, J., Gandarillas, M. et al. Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens. Bone Marrow Transplant 27, 405–412 (2001). https://doi.org/10.1038/sj.bmt.1702795

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