nach oben

Erschienen in:

01.09.2012 | Original Article

High-dose thiotepa, etoposide and carboplatin as conditioning regimen for autologous stem cell transplantation in patients with high-risk non-Hodgkin lymphoma

verfasst von: Franca Falzetti, Mauro Di Ianni, Stelvio Ballanti, Giuseppe Iodice, Antonia Reale, Olivia Minelli, Gabriella Serio, Massimo F. Martelli, Franco Dammacco, Angelo Vacca, Roberto Ria

Erschienen in: Clinical and Experimental Medicine | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

High-dose chemotherapy conditioning regimens followed by autologous stem cell transplantation generally provide good results in non-Hodgkin lymphoma. We have evaluated the effects of a high-dose regimen comprising thiotepa, etoposide and carboplatin. After debulking and mobilization with high-dose cyclophosphamide or other schedules, forty-five patients at various disease stages were conditioned with thiotepa, etoposide and carboplatin prior to autologous stem cell transplantation. The overall response rate was 77.8% (30 CR, 66.7%; 5 PR, 11.1%). Ten patients (22.2%) did not respond. Two patients (4.4%) died from transplant-related complications. The mean 5-year overall survival was 71.1%: 12 patients relapsed within the first 5 years of follow-up. The overall response rate and 5-year overall survival were better for patients with an International Prognostic Index (IPI) 1 at diagnosis than for those with IPI 2 and IPI 3 (P < 0.005 for all). The thiotepa, etoposide and carboplatin conditioning regimen for autologous stem cell transplantation in non-Hodgkin lymphoma has a good anti-lymphoma effect and provides encouraging results in terms of response to treatment and 5-year overall survival. Its good tolerance and acceptable toxicity suggest that it may a very useful in the management of non-Hodgkin lymphoma.

Garber K (2001) Lymphoma rate rise continues to baffle researchers. J Natl Cancer Inst 93:494–496PubMedCrossRef

Salles G, Coiffier B (1999) Autologous peripheral blood stem cell transplantation for non-Hodgkin’s lymphoma. Baillieres Best Pract Res Clin Haematol 12:151–169PubMedCrossRef

Rohatiner AZ, Johnson PW, Price CG, Arnott SJ, Amess JA, Norton AJ, Dorey E, Adams K, Whelan JS, Matthews J (1994) Myeloablative therapy with autologous bone marrow transplantation as consolidation therapy for recurrent follicular lymphoma. J Clin Oncol 12:1177–1184PubMed

Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, Coiffier B, Biron P et al (1995) Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy sensitive non-Hodgkin’s lymphoma. N Engl J Med 333:1540–1545PubMedCrossRef

Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP (1993) Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma. N Engl J Med 328:1002–1006PubMedCrossRef

Aksentijevich I, Jones RJ, Ambinder RF, Garrett-Mayer E, Flinn IW (2006) Clinical outcome following autologous and allogeneic blood and marrow transplantation for relapsed diffuse large-cell non-Hodgkin’s lymphoma. Biol Blood Marrow Transplant 12:965–972PubMedCrossRef

Josting A, Reiser M, Rueffer U, Salzberger B, Diehl V, Engert A (2000) Treatment of primary progressive Hodgkin’s and aggressive non-Hodgkin’s lymphoma: is there a chance for cure? J Clin Oncol 18:332–339PubMed

Vose JM (1998) High-dose chemotherapy and hematopoietic stem cell transplantation for relapsed or refractory diffuse large-cell non-Hodgkin’s lymphoma. Ann Oncol 9(Suppl 1):S1–S3PubMedCrossRef

Shipp MA, Abeloff MD, Antman KH, Carroll G, Hagenbeek A, Loeffler M, Montserrat E, Radford JA, Salles G, Schmitz N, Symann M, Armitage JO et al (1999) International consensus conference on high-dose therapy with hematopoietic stem cell transplantation in aggressive non-Hodgkin’s lymphomas: report of the jury. J Clin Oncol 17:423–429PubMed

10.

Lee MS, Chang KS, Cabanillas F, Freireich EJ, Trujillo JM, Stass SA (1987) Detection of minimal residual cells carrying the t(14;18) by DNA sequence amplification. Science 237:175–178PubMedCrossRef

11.

Sharp JG, Joshi SS, Armitage JO, Bierman P, Coccia PF, Harrington DS, Kessinger A, Crouse DA, Mann SL, Weisenburger DD (1992) Significance of detection of occult non-Hodgkin’s lymphoma in histologically uninvolved bone marrow by a culture technique. Blood 79:1074–1080PubMed

12.

Chopra R, McMillan AK, Linch DC, Yuklea S, Taghipour G, Pearce R, Patterson KG, Goldstone AH (1993) The place of high-dose BEAM therapy and autologous bone marrow transplantation in poor-risk Hodgkin’s disease. A single-center eight-year study of 155 patients. Blood 81:1137–1145PubMed

13.

Stiff PJ, Dahlberg S, Forman SJ, McCall AR, Horning SJ, Nademanee AP, Blume KG, LeBlanc M, Fisher RI (1998) Autologous bone marrow transplantation for patients with relapsed or refractory diffuse aggressive non-Hodgkin’s lymphoma: value of augmented preparative regimens—a Southwest Oncology Group trial. J Clin Oncol 16:48–55PubMed

14.

Papadopoulos KP, Noguera-Irizarry W, Wiebe L, Hesdorffer CS, Garvin J, Nichols GL, Vahdat LH, Lo KM, Skerrett D, Bernstein D, Sharpe E, Savage DG (2005) Pilot study of tandem high-dose chemotherapy and autologous stem cell transplantation with a novel combination of regimens in patients with poor risk lymphoma. Bone Marrow Transpl 36:491–497CrossRef

15.

Ahmed T, Rashid K, Waheed F, Kancherla R, Qureshi Z, Hoang A, Richter J, Ali MF, Goldberg R, Liu D, Seiter K (2005) Long-term survival of patients with resistant lymphoma treated with tandem stem cell transplant. Leuk Lymphoma 46:405–414PubMedCrossRef

16.

Glossmann JP, Staak JO, Nogova L, Diehl V, Scheid C, Kisro J, Reis HE, Peter N, Engert A, Josting A (2005) Autologous tandem transplantation in patients with primary progressive or relapsed/refractory lymphoma. Ann Hematol 84:517–525PubMedCrossRef

17.

Fontelonga A, Kelly AJ, MacKintosh FR, Hall S, Monroe P, Wilson GS, Shaft D, Ruthven A, Ascensao JL (1997) A novel high-dose chemotherapy protocol with autologous hematopoietic rescue in patients with metastatic breast cancer or recurrent non-Hodgkin’s lymphoma. Bone Marrow Transpl 19:983–988CrossRef

18.

Chaudhary UB, Damon LE, Rugo HS, Linker CA, Navarro W, Small EJ (2005) High-dose etoposide, thiotepa, and dose-adjusted carboplatin (TVCa) with autologous hematopoietic stem cell rescue as treatment of relapsed or refractory germ cell cancer. Am J Clin Oncol 28:130–137PubMedCrossRef

19.

Bearman SI, Appelbaum FR, Back A, Petersen FB, Buckner CD, Sullivan KM, Schoch HG, Fisher LD, Thomas ED (1988) Regimen-related toxicity in patients undergoing bone marrow transplantation. J Clin Oncol 6:1562–1568PubMed

20.

Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 135:185

21.

Longo DL, Duffey PL, Young RC, Hubbard SM, Ihde DC, Glatstein E, Phares JC, Jaffe ES, Urba WJ, DeVita VT Jr (1992) Conventional-dose salvage combination chemotherapy in patients relapsing with Hodgkin’s disease after combination chemotherapy: the low probability for cure. J Clin Oncol 10:210–218PubMed

22.

Saez R, Dahlberg S, Appelbaum FR, Hartsock RJ, Lemaistre F, Coltman CA Jr, Fisher RI (1994) Autologous bone marrow transplantation in adults with non-Hodgkin’s lymphoma: a Southwest Oncology Group study. Hematol Oncol 12:75–85PubMedCrossRef

23.

Cabanillas F, Velasquez WS, McLaughlin P, Jagannath S, Hagemeister FB, Redman JR, Swan F, Rodriguez MA (1988) Results of recent salvage chemotherapy regimens for lymphoma and Hodgkin’s disease. Semin Hematol 25(Suppl 2):47–50PubMed

24.

Gianni AM, Bregni M, Siena S, Brambilla C, Di Nicola M, Lombardi F, Gandola L, Tarella C, Pileri A, Ravagnani F, Valagussa P, Bonadonna G (1997) High dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma. N Engl J Med 336:1290–1297PubMedCrossRef

25.

Haioun C, Lepage E, Gisselbrecht C, Salles G, Coiffier B, Brice P, Bosly A, Morel P, Nouvel C, Tilly H, Lederlin P, Sebban C et al (2000) Survival benefit of high dose therapy in poor risk non Hodgkin’s lymphoma: final analysis of the prospective LNH87-2 protocol, a groupe d’Etude des lymhomes de l’Adulte study. J Clin Oncol 18:3025–3030PubMed

26.

Kaiser U, Uebelacker I, Abel U, Birkmann J, Trümper L, Schmalenberg H, Karakas T, Metzner B, Hossfeld DK, Bischoff HG, Franke A, Reiser M et al (2002) Randomized study to evaluate the use of high-dose therapy as part of primary treatment for “Aggressive” lymphoma. J Clin Oncol 20:4413–4419PubMedCrossRef

27.

Martelli M, Gherlinzoni F, De Renzo A, Zinzani PL, De Vivo A, Cantonetti M, Falini B, Storti S, Meloni G, Rizzo M, Molinari AL, Lauria F et al (2003) Early autologous stem-cell transplantation versus conventional chemotherapy as front-line therapy in high-risk, aggressive non-Hodgkin’s lymphoma: an Italian multicenter randomised trial. J Clin Oncol 21:1255–1262PubMedCrossRef

28.

Milpied N, Deconinck E, Gaillard F, Delwail V, Foussard C, Berthou C, Gressin R, Lucas V, Colombat P, Harousseau JL (2004) Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. Groupe Ouest-Est des Leucemies et des Autres Maladies du Sang. N Engl J Med 350:1287–1295PubMedCrossRef

29.

Gisselbrecht C, Lepage E, Molina T, Quesnel B, Fillet G, Lederlin P, Coiffier B, Tilly H, Gabarre J, Guilmin F, Hermine O, Reyes F (2002) Shortened first-line high dose chemotherapy for patients with poor-prognosis aggressive lymphoma. Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol 20:2472–2479PubMedCrossRef

30.

Shipp MA, Neuberg D, Janicek M, Canellos GP, Shulman LN (1995) High-dose CHOP as initial therapy for patients with poor-prognosis aggressive non-Hodgkin’s lymphoma: a dose-finding pilot study. J Clin Oncol 13:2916–2923PubMed

31.

Tilly H, Mounier N, Lederlin P, Brière J, Dupriez B, Sebban C, Bosly A, Biron P, Nouvel C, Herbrecht R, Bordessoule D, Coiffier B (2000) Randomized comparison of ACVBP and m-BACOD in the treatment of patients with low-risk aggressive lymphoma: the LNH87-1 study. J Clin Oncol 18:1309–1315PubMed

32.

Talbot SM, Westerman DA, Grigg AP, Toner GC, Wolf M, Bishop J, McKendrick J, Zalcberg J, Levi J, Fox RM, Green MD (1999) Phase I and subsequent phase II study of filgrastim (r-met-HuG-CSF) and dose intensified cyclophosphamide plus epirubicine in patients with non-Hodgkin’s lymphoma and advanced solid tumors. Ann Oncol 10:907–914PubMedCrossRef

33.

Blayney DW, LeBlanc ML, Grogan T, Gaynor ER, Chapman RA, Spiridonidis CH, Taylor SA, Bearman SI, Miller TP, Fisher RI (2003) Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma: a phase II study of the Southwest Oncology Group (SWOG 9349). J Clin Oncol 21:2466–2473PubMedCrossRef

34.

Balzarotti M, Spina M, Sarina B, Magagnoli M, Castagna L, Milan I, Ripa C, Latteri F, Bernardi D, Bertuzzi A, Nozza A, Roncalli M et al (2002) Intensified CHOP regimen in aggressive lymphomas: maximal dose intensity and dose density of doxorubicin and cyclophosphamide. Ann Oncol 13:1341–1346PubMedCrossRef

35.

Meyer RM, Quirt IC, Skillings JR, Cripps MC, Bramwell VH, Weinerman BH, Gospodarowicz MK, Burns BF, Sargeant AM, Shepherd LE, Zee B, Hryniuk WM (1993) Escalated as compared with standard doses of doxorubicin in BACOP therapy for patients with non-Hodgkin’s lymphoma. N Engl J Med 329:1770–1776PubMedCrossRef

36.

Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A, Attal M, Fillet G, Guettier C, Molina TJ, Gisselbrecht C, Reyes F (2003) Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin’s lymphoma. Groupe d’Etude des Lymphomes de l’Adulte. Blood 102:4284–4289PubMedCrossRef

37.

Pfreundschuh M, Trumper L, Kloess M, Schmits R, Feller AC, Rübe C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B et al (2004) Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood 104:626–633PubMedCrossRef

38.

Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N et al (2004) Two-weekly or 3-weekly CHOP Chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. German High-Grade Non-Hodgkin’s Lymphoma Study Group. Blood 104:634–641PubMedCrossRef

39.

Milligan DW, Ruiz De Elvira MC, Kolb HJ, Goldstone AH, Meloni G, Rohatiner AZ, Colombat P, Schmitz N (1999) Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT. EBMT Lymphoma and Late Effects Working Parties. European Group for Blood and Marrow Transplantation. Br J Haematol 106:1020–1026PubMedCrossRef

40.

Vitolo U, Liberati AM, Cabras MG, Federico M, Angelucci E, Baldini L, Boccomini C, Brugiatelli M, Calvi R, Ciccone G, Genua A, Deliliers GL, Levis A, Parvis G, Pavone E, Salvi F, Sborgia M, Gallo E, Intergruppo Italiano Linfomi (2005) High dose sequential chemotherapy with autologous transplantation versus dose-dense chemotherapy MegaCEOP as first line treatment in poor-prognosis diffuse large cell lymphoma: an “Intergruppo Italiano Linfomi” randomized trial. Haematologica 90:793–801PubMed

Titel: High-dose thiotepa, etoposide and carboplatin as conditioning regimen for autologous stem cell transplantation in patients with high-risk non-Hodgkin lymphoma
verfasst von: Franca Falzetti
Mauro Di Ianni
Stelvio Ballanti
Giuseppe Iodice
Antonia Reale
Olivia Minelli
Gabriella Serio
Massimo F. Martelli
Franco Dammacco
Angelo Vacca
Roberto Ria
Publikationsdatum: 01.09.2012
Verlag: Springer Milan
Erschienen in: Clinical and Experimental Medicine / Ausgabe 3/2012
Print ISSN: 1591-8890
Elektronische ISSN: 1591-9528
DOI: https://doi.org/10.1007/s10238-011-0157-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

High-dose thiotepa, etoposide and carboplatin as conditioning regimen for autologous stem cell transplantation in patients with high-risk non-Hodgkin lymphoma

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Costims – das nächste heiße Ding in der Krebstherapie?

Perioperative Checkpointhemmer-Therapie verbessert NSCLC-Prognose

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

Update Innere Medizin

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2012

A phase I pilot trial of MUC1-peptide-pulsed dendritic cells in the treatment of advanced pancreatic cancer

Altered IL-10 and TNF-α production in peripheral blood mononuclear cells of systemic lupus erythematosus patients after Toll-like receptor 2, 4, or 9 activation

Comparison of circadian characteristics for cytotoxic lymphocyte subsets in non-small cell lung cancer patients versus controls

Discovery of serum protein biomarkers in rheumatoid arthritis using MALDI-TOF-MS combined with magnetic beads

Malignant tumor-like gastric lesion due to candida albicans in a diabetic patient treated with cyclosporin: a case report and review of the literature

VP22 enhances the expression of glucocerebrosidase in human Gaucher II fibroblast cells mediated by lentiviral vectors

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Costims – das nächste heiße Ding in der Krebstherapie?

Perioperative Checkpointhemmer-Therapie verbessert NSCLC-Prognose

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

Update Innere Medizin