Autologous stem cell transplantation for non-Hodgkin's lymphoma: Comparison of radiation-based and chemotherapy-only preparative regimens

F. Gutierrez-Delgado, D. G. Maloney, O. W. Press, J. Golden, L. A. Holmberg, Richard Maziarz, H. Hooper, C. D. Buckner, F. R. Appelbaum, W. I. Bensinger

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31 Scopus citations

Abstract

The aim of this study was to compare toxicity and efficacy of total body irradiation (TBI), cyclophosphamide (CY) and etoposide (E) (TBI/CY/E) vs busulfan, melphalan and thiotepa (Bu/Mel/T) in patients receiving autologous stem cell infusion (ASCI) for malignant lymphoma (NHL). Between September 1990 and July 1998, 351 patients with NHL were treated with TBI/CY/E (n = 221) or Bu/Mel/T (n = 130) followed by ASCI. Patients in first, or second remission, first responding or untreated relapse were defined as having less advanced disease before transplantation. The median follow-up was 5 years (range 1-9) and 3.5 years (1-6) for patients receiving TBI/CY/E and Bu/Mel/T, respectively. The cumulative probabilities of survival, event-free survival (EFS) and relapse at 5 years were 44%, 32%, 49% following TBI/CY/E and 42%, 34% and 42% following Bu/Mel/T. The probability of EFS at 5 years for patients who had prior dose-limiting radiation (n = 59) was 32% after Bu/Mel/T therapy. Transplant-related mortality was 16% for TBI/CY/E and 21% for Bu/Mel/T. In univariate and multivariate analyses, more advanced disease status was associated with poor outcome (TBI/CY/E: RR 0.70, CI 0.50 to 0.97 P = 0.04; Bu/Mel/T: RR 0.61, CI 0.39 to 0.97 P = 0.03). No significant differences in toxicities and outcomes were observed between these two regimens despite the inclusion of patients who had received dose-limiting irradiation in the Bu/Mel/T regimen.

Original languageEnglish (US)
Pages (from-to)455-461
Number of pages7
JournalBone Marrow Transplantation
Volume28
Issue number5
DOIs
Publication statusPublished - 2001
Externally publishedYes

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Keywords

  • Busulfan
  • High-dose chemotherapy
  • Lymphomas
  • Melphalan
  • Stem cell transplantation
  • Thiotepa

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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