High-dose busulfan, melphalan, and thiotepa followed by autologous peripheral blood stem cell transplantation in patients with aggressive lymphoma or relapsed Hodgkin's disease

Kathy Schiffman, C. Dean Buckner, Richard Maziarz, David G. Maloney, Frederick R. Appelbaum, Oliver Press, Ted Gooley, Leona Holmberg, Kathy Lilleby, Reginald Clift, Norman Zuckerman, Jay Klarnet, Charles Weaver, Thomas Chauncey, William I. Bensinger

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

The purpose of this study was to evaluate the efficacy of high-dose chemotherapy with busulfan (Bu), melphalan (Mel), and thiotepa (TT), and of autologous peripheral blood stem cell (PBSC) infusion in patients with aggressive non-Hodgkin's lymphoma (NHL) or relapsed Hodgkin's disease (HD). Forty patients, 23 with intermediate (n=18) or high-grade (n=5) NHL and 17 with HD received Bu (12 mg/kg), Mel (100 mg/kg), TT (450-500 mg/kg), and autologous PBSC infusion. Of 27 patients with more advanced disease, 16 had primary refractory disease, 8 were in refractory relapse, and 3 were in third remission. Of 13 patients with less advanced disease, 7 were in untreated or responding first relapse and 3 were in second remission, whereas 3 with high-grade NHL were in first remission. Twenty-nine patients (73%) had received prior radiotherapy (RT) prohibiting a total-body irradiation (TBI)-based conditioning regimen. The projected 2-year probabilities of survival, event-free survival, and relapse for all patients were 0.60, 0.46, and 0.31 (0.85, 0.85, and 0.15 for patients with less advanced disease and 0.48, 0.30, and 0.37 for patients with more advanced disease). The probability of nonrelapse mortality in the first 100 days was 0.17. Severe idiopathic pneumonia syndrome was not observed in any patients with less advanced disease and in only one patient with more advanced disease. A regimen of BuMeIlT is well tolerated in patients with aggressive NHL or relapsed HD, and results obtained to date are at least equivalent to other published regimens, including TBI-based regimens. This regimen appears to be a particularly attractive alternative for patients who have already received dose-limiting RT and should be evaluated further in prospective, randomized studies.

Original languageEnglish (US)
Pages (from-to)261-266
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume3
Issue number5
StatePublished - Nov 1 1997

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Keywords

  • Autologous stem cell transplant
  • Hodgkin's Disease
  • Non-Hodgkin's lymphoma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Schiffman, K., Buckner, C. D., Maziarz, R., Maloney, D. G., Appelbaum, F. R., Press, O., Gooley, T., Holmberg, L., Lilleby, K., Clift, R., Zuckerman, N., Klarnet, J., Weaver, C., Chauncey, T., & Bensinger, W. I. (1997). High-dose busulfan, melphalan, and thiotepa followed by autologous peripheral blood stem cell transplantation in patients with aggressive lymphoma or relapsed Hodgkin's disease. Biology of Blood and Marrow Transplantation, 3(5), 261-266.