TY - JOUR
T1 - Immunochemotherapy and autologous stem-cell transplantation for untreated patients with mantle-cell lymphoma
T2 - CALGB 59909
AU - Damon, Lloyd E.
AU - Johnson, Jeffrey L.
AU - Niedzwiecki, Donna
AU - Cheson, Bruce D.
AU - Hurd, David D.
AU - Bartlett, Nancy L.
AU - LaCasce, Ann S.
AU - Blum, Kristie A.
AU - Byrd, John C.
AU - Kelly, Michael
AU - Stock, Wendy
AU - Linker, Charles A.
AU - Canellos, George P.
PY - 2009/12/20
Y1 - 2009/12/20
N2 - Purpose: Mantle-cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin's lymphoma with a poor prognosis. We explored the feasibility, safety, and effectiveness of an aggressive immunochemotherapy treatment program that included autologous stem-cell transplantation (ASCT) for patients up to age 69 years with newly diagnosed MCL. Patients and Methods: The primary end point was 2-year progression-free survival (PFS). A successful trial would yield a 2-year PFS of at least 50% and an event rate (early progression plus nonrelapse mortality) less than 20% at day +100 following ASCT. Seventy-eight patients were treated with two or three cycles of rituximab combined with methotrexate and augmented CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). This treatment was followed by intensification with high doses of cytarabine and etoposide combined with rituximab and filgrastim to mobilize autologous peripheral-blood stem cells. Patients then received high doses of carmustine, etoposide, and cyclophosphamide followed by ASCT and two doses of rituximab. Results: There were two nonrelapse mortalities, neither during ASCT. With a median follow-up of 4.7 years, the 2-year PFS was 76% (95% CI, 64% to 85%), and the 5-year PFS was 56% (95% CI, 43% to 68%). The 5-year overall survival was 64% (95% CI, 50% to 75%). The event rate by day + 100 of ASCT was 5.1%. Conclusion: The Cancer and Leukemia Group B 59909 regimen is feasible, safe, and effective in patients with newly diagnosed MCL. The incorporation of rituximab with aggressive chemotherapy and ASCT may be responsible for the encouraging outcomes demonstrated in this study, which produced results comparable to similar treatment regimens.
AB - Purpose: Mantle-cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin's lymphoma with a poor prognosis. We explored the feasibility, safety, and effectiveness of an aggressive immunochemotherapy treatment program that included autologous stem-cell transplantation (ASCT) for patients up to age 69 years with newly diagnosed MCL. Patients and Methods: The primary end point was 2-year progression-free survival (PFS). A successful trial would yield a 2-year PFS of at least 50% and an event rate (early progression plus nonrelapse mortality) less than 20% at day +100 following ASCT. Seventy-eight patients were treated with two or three cycles of rituximab combined with methotrexate and augmented CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). This treatment was followed by intensification with high doses of cytarabine and etoposide combined with rituximab and filgrastim to mobilize autologous peripheral-blood stem cells. Patients then received high doses of carmustine, etoposide, and cyclophosphamide followed by ASCT and two doses of rituximab. Results: There were two nonrelapse mortalities, neither during ASCT. With a median follow-up of 4.7 years, the 2-year PFS was 76% (95% CI, 64% to 85%), and the 5-year PFS was 56% (95% CI, 43% to 68%). The 5-year overall survival was 64% (95% CI, 50% to 75%). The event rate by day + 100 of ASCT was 5.1%. Conclusion: The Cancer and Leukemia Group B 59909 regimen is feasible, safe, and effective in patients with newly diagnosed MCL. The incorporation of rituximab with aggressive chemotherapy and ASCT may be responsible for the encouraging outcomes demonstrated in this study, which produced results comparable to similar treatment regimens.
UR - http://www.scopus.com/inward/record.url?scp=74949115388&partnerID=8YFLogxK
U2 - 10.1200/JCO.2009.22.2554
DO - 10.1200/JCO.2009.22.2554
M3 - Article
C2 - 19917845
AN - SCOPUS:74949115388
SN - 0732-183X
VL - 27
SP - 6101
EP - 6108
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 36
ER -